Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study
Abstract Background To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures. Methods Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-09-01
|
Series: | BMC Musculoskeletal Disorders |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12891-018-2247-8 |
id |
doaj-d588cf3f633d46b8b0a4c2667ec2609c |
---|---|
record_format |
Article |
spelling |
doaj-d588cf3f633d46b8b0a4c2667ec2609c2020-11-25T01:15:10ZengBMCBMC Musculoskeletal Disorders1471-24742018-09-011911710.1186/s12891-018-2247-8Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric studyQiuke Wang0Yifei Liu1Ming Zhang2Yu Zhu3Lei Wang4Yunfeng Chen5Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalAbstract Background To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures. Methods Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were placed on the proximal humerus. Head screws penetrating 1 mm into the joint were fitted one by one. Fluoroscopy was conducted in the 180° horizontal plane and the 120° coronal plane to analyze each screw’s penetration in every shoulder. Images were taken every 5°, then all images were analyzed to identify the sensitive angles. Results The range of optimal viewing angles to visualize penetration of every head screw was identified. In the coronal plane, the angles in the range between 0° and 10° were sensitive to all screws except No. 8 and No. 9. Furthermore, penetration of screws No. 8 and 9 could not be identified on any axillary view, but could be identified in the horizontal plane from − 30° to − 10° and from 10° to 35° respectively. Conclusions We recommend a 0°–10° axillary view with 30° arm abduction combined with two horizontal angles in the range of − 30° to − 10° and 10° to 35° for routine fluoroscopy during surgery. Our results will be helpful in avoiding primary screw penetration.http://link.springer.com/article/10.1186/s12891-018-2247-8Proximal humeral fractureScrew penetrationComplicationFluoroscopySurgeryTrauma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Qiuke Wang Yifei Liu Ming Zhang Yu Zhu Lei Wang Yunfeng Chen |
spellingShingle |
Qiuke Wang Yifei Liu Ming Zhang Yu Zhu Lei Wang Yunfeng Chen Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study BMC Musculoskeletal Disorders Proximal humeral fracture Screw penetration Complication Fluoroscopy Surgery Trauma |
author_facet |
Qiuke Wang Yifei Liu Ming Zhang Yu Zhu Lei Wang Yunfeng Chen |
author_sort |
Qiuke Wang |
title |
Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study |
title_short |
Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study |
title_full |
Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study |
title_fullStr |
Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study |
title_full_unstemmed |
Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study |
title_sort |
optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2018-09-01 |
description |
Abstract Background To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures. Methods Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were placed on the proximal humerus. Head screws penetrating 1 mm into the joint were fitted one by one. Fluoroscopy was conducted in the 180° horizontal plane and the 120° coronal plane to analyze each screw’s penetration in every shoulder. Images were taken every 5°, then all images were analyzed to identify the sensitive angles. Results The range of optimal viewing angles to visualize penetration of every head screw was identified. In the coronal plane, the angles in the range between 0° and 10° were sensitive to all screws except No. 8 and No. 9. Furthermore, penetration of screws No. 8 and 9 could not be identified on any axillary view, but could be identified in the horizontal plane from − 30° to − 10° and from 10° to 35° respectively. Conclusions We recommend a 0°–10° axillary view with 30° arm abduction combined with two horizontal angles in the range of − 30° to − 10° and 10° to 35° for routine fluoroscopy during surgery. Our results will be helpful in avoiding primary screw penetration. |
topic |
Proximal humeral fracture Screw penetration Complication Fluoroscopy Surgery Trauma |
url |
http://link.springer.com/article/10.1186/s12891-018-2247-8 |
work_keys_str_mv |
AT qiukewang optimalviewinganglesofintraoperativefluoroscopyfordetectingscrewpenetrationinproximalhumeralfracturesacadavericstudy AT yifeiliu optimalviewinganglesofintraoperativefluoroscopyfordetectingscrewpenetrationinproximalhumeralfracturesacadavericstudy AT mingzhang optimalviewinganglesofintraoperativefluoroscopyfordetectingscrewpenetrationinproximalhumeralfracturesacadavericstudy AT yuzhu optimalviewinganglesofintraoperativefluoroscopyfordetectingscrewpenetrationinproximalhumeralfracturesacadavericstudy AT leiwang optimalviewinganglesofintraoperativefluoroscopyfordetectingscrewpenetrationinproximalhumeralfracturesacadavericstudy AT yunfengchen optimalviewinganglesofintraoperativefluoroscopyfordetectingscrewpenetrationinproximalhumeralfracturesacadavericstudy |
_version_ |
1725154150975537152 |