Abstract

MATTHEE, W; ROBERTSON, AJF  and  BARROW, AD. Standardised post-operative radiographs for volar radial plate fixation: the '22/11 X-ray'. SA orthop. j. [online]. 2017, vol.16, n.3, pp.62-69. ISSN 2309-8309.  http://dx.doi.org/10.17159/2309-8309/2017/v16n3a9.

BACKGROUND: The current standard post-operative radiographs 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. Our aim was to determine: 1) if anatomically tilted post-operative radiographs increased the observer's confidence with regard to assessment of screw position, and 2) the intra- and inter-observer reliability of these radiographs. METHODS: Thirty patients' standard and tilted (11 ° postero-anterior 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 of actual screw position 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 substantial when the intern's observations were excluded. CONCLUSIONS: The routine acquisition of the tilted PA radiograph can assist senior health professionals with important patient management decisions. LEVEL OF EVIDENCE: Level II.

Keywords : anatomically tilted; radiographs; X-rays; distal radius; volar locking plate.

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