Abstract
Purpose: To evaluate the effect of three-dimensional virtual pre-operative planning (3DVP) on the incidence of dorsal screw penetration after volar plating of distal radius fractures. Methods: A cross-sectional diagnostic imaging study was performed. Twenty out of 50 patients were randomly selected from our index prospective cohort (IPC): a prior study evaluating dorsal tangential views (DTVs) in reducing dorsal screw penetration in internal fixation of intra-articular distal radius fractures using post-operative CT scans to quantify screw protrusion. Pre-operative CTs from this cohort were now used for 3DVP by three experienced orthopaedic trauma surgeons (supplementary video). 3DVP was compared with the corresponding post-operative CT for assessing screw lengths and incidence of dorsal penetration. The Wilcoxon Signed Ranks test was used to compare screw lengths and the Fishers’ exact for incidence of penetration. Results: Three surgeons performed 3DVP for 20 distal radius fractures and virtually applied 60 volar plates and 273 screws. Median screw length was shorter in the 3DVP when compared to IPC: 18 mm (range, 12–22) versus 20 mm (range, 14–26) (p < 0.001). The number of penetrating screws was 5% (13/273 screws) in the 3DVP group compared to 11% (10/91 screws) in the IPC (p = 0.047). Corresponding to a reduction in incidence of at least one dorsally penetrating screw in 40% of patients in the IPC group, to 18% in the 3DVP group (p = 0.069). Conclusion: Three-Dimensional Virtual Pre-Operative Planning (3DVP) may reduce the incidence of dorsally penetrating screws in patients treated with volar plating for intra-articular distal radius fractures. Level of evidence: II, diagnostic imaging study.
| Original language | English |
|---|---|
| Pages (from-to) | 3911-3921 |
| Number of pages | 11 |
| Journal | European Journal of Trauma and Emergency Surgery |
| Volume | 48 |
| Issue number | 5 |
| Early online date | 8 Oct 2021 |
| DOIs | |
| Publication status | Published - Oct 2022 |
Bibliographical note
Funding Information:One author (JP) certifies that he has received, an amount less than USD 15,000 from the Michael van Vloten Foundation (Rotterdam, The Netherlands), an amount less than USD 10,000 from ZonMw (Den Haag, The Netherlands), and an amount less than USD 10,000 from the Prins Bernhard Cultuur Fonds (Amsterdam, The Netherlands). One author (JND) certifies that he has received an unrestricted Postdoc Research Grant from the Marti-Keuning-Eckhardt Foundation. One author (RJ) has provided paid lectures for DePuy-Synthes and Smith & Nephew.
Funding Information:
We are thankful for the free trial of SECTRA 3D Virtual Planning software that was generously provided by SECTRA (Sweden) to the senior authors, that led us to explore this application to answer the current study question and execution of this study on our convenience sample dataset that was previously published. The Traumaplatform 3D Consortium includes N. Assink, G. Bain, L. Brouwers, K. ten Duis, M. Inglis, B. Jadav, G.M.M.J. Kerkhoffs, D.W.G. Langerhuizen, A.M.L Meesters, P. Nieboer, J. White, D. Worsley.
Publisher Copyright:
© 2021, The Author(s).