Influence of training on dorsal tangential radiographic view to detect screw protrusion after anterior plating of the distal radius: a cadaveric study

Minke Bergsma, Miryam C. Obdeijn, Stein J. Janssen, Gregory I. Bain, Ruurd L. Jaarsma, Job N. Doornberg

Research output: Contribution to journalArticlepeer-review

Abstract

In this cadaveric study of anterior plating of the distal radius, we aimed to determine the interobserver agreement and diagnostic performance for detecting dorsally protruding screws using the dorsal tangential radiographic view before and after specific training. Without prior instruction, 13 observers interpreted the dorsal tangential view of cadaveric specimens, in which anterior radial plates were placed. After seeing a training video on the dorsal tangential view, they repeated the task. Though we found that accuracy and interobserver agreement was lower than described in some other clinical series, training led to statistically significant improvements of (1) the interobserver agreement on the decision to exchange screws, (2) the self-confidence of the surgeon in obtaining adequate views, and (3) the number of fluoroscopic images required to obtain these views. After training, the number of protruding screws missed was reduced by 36%, but 7% of dorsally protruding screws was still missed.

Original languageEnglish
Pages (from-to)864-870
Number of pages7
JournalJournal of Hand Surgery: European Volume
Volume45
Issue number8
Early online date10 Feb 2020
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • distal radius fractures
  • Dorsal screw penetration
  • dorsal tangential view
  • training
  • volar plating

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