Standardised post-operative radiographs for volar radial plate fixation: The "22/11 X-ray"
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Date
2014-04-08
Authors
Matthee, Warren
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Abstract
The current standard post-operative X-rays for patients who have had volar locking plate fixation for a distal radius fracture may give the impression of intra-articular screw placement due to the normal anatomic inclination of the radiocarpal joint.
Aim: To determine:
1. If anatomically tilted post-operative radiographs increased the observer’s confidence with regard to assessment of screw position.
2. The intra- and inter-observer reliability of these X-rays.
Materials and Methods: 30 patients’ standard and tilted (11° PA and 22° lateral) post-operative radiographs were assessed by an orthopaedic intern, registrar, consultant, and a radiologist on two occasions. Single and combined views were analysed.
Results: There was no difference in confidence of assessment, but there was a significant change of assessment with fewer intra-articular penetrations reported with the tilted PA view. There was low intra-observer reliability except for the consultant orthopaedic surgeon. Inter-observer reliability was good when the intern’s observations were excluded.
Conclusion: The routine acquisition of the tilted PA radiograph can assist senior health professionals with important patient management decisions.