Comparison of ultrasound and dorsal horizon radiographic view for the detection of dorsal screw penetration

Abstract

Objective: The aim of this study was to compare the efŞciency of dorsal tangential fluoroscopy and ultrasonography in detecting dorsal screw penetration in distal radius volar locking plate applications.Methods: Ten cadaveric forearms were operated. The distal four screws were protruded 0, 1 and 2 mminto each of the second, third and fourth dorsal compartments of distal radius. Dorsal horizon views weretaken usingfluoroscopy. Each radiographic image was evaluated by two orthopedic surgeons who areblinded to procedure. Sonographic evaluations were performed by an orthopedic surgeon blinded to theprocedure. Both dorsal horizon view and ultrasonography assessments were noted by the evaluatorswhether the tip of the screw penetrated or not the dorsal cortex for each compartment.Results: No signiŞcant difference was observed on correct detection of 0 mm, 1 mm and 2 mm screwpenetrations at second and third compartments. In the fourth compartment, there was no differencewith 0 mm and 2 mm penetrations but correct detection accuracy of 1 mm screw penetration was 87% inultrasonography group and 71% in dorsal horizon view group.Conclusions: The accuracy of ultrasonography on 1 mm penetration at the fourth compartment is betterthan dorsal horizon view. However, dorsal horizon view and ultrasonography accuracy is similar for theother compartments and penetration levels. Ultrasonography is a reliable and effective procedure fordetection of dorsal screw penetrations.Level of evidence: Level III, Diagnostic study.