Usefulness of Intraoperative Ultrasound in a Volar Plate Distal Radius Fixation

Study Overview
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Brief Summary
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Distal radius fracture is a common injury with a high percentage of surgical treatment. In the last decades, volar plate fixation has been the treatment of choice. However, complication rates range between 6% and 50% according to the different study groups. One of the main complications is due to errors in screw measurement given the particular anatomy of the distal radius. Numerous views in addition to the standard ones have been described in order to increase the specificity and sensitivity in the detection of poorly implanted screws. In the absence of a radiological projection superior to another, we believe that the use of intraoperative ultrasound can provide a non-invasive and quick revision element that avoids scope time for both: the patient and the surgical team.

Detailed Description
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Patients will be recruited in a sequential mode after signing the usual informed consent (IC) as well as the consent to accept participation in the study. The intervention will be carried out as usual and, once the radiological checks have been carried out, an ultrasound of the wrist extensor compartments will be performed. Compartments will be studied individually in order to detect invasion of the dorsal cortex by the screws. All surgeries will be performed only by members of the upper limb trauma team or hand surgery unit. Postoperative follow-up will be the standard one prior to the present study.

Official Title
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Is Ultrasound Valid in Distal Radius Fixation With a Volar Plate?

Conditions
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Distal Radius Fracture, Ultrasound

Intervention / Treatment
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* Diagnostic Test: Intraoperative ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over 18 years of age Both sexes Surgical criteria distal radius fracture. Patients with sufficient understanding capacity to read and understand an informed consent. Exclusion Criteria: Patients with a history of any type of surgical intervention on the same limb distal to the elbow.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study group<br>Patients with a distal radius fracture requiring surgery who meet the exclusion and inclusion criteria | Diagnostic Test: Intraoperative ultrasound<br>* During the surgery, the standard AP and lateral x-rays will be performed. Additional projections (lateral 30 degrees tilt, and dorsal tangential view) will also be registered. Finally an intraoperative ultrasound of the wrist extensor tendons will be taken, checking the compartments individually in order to detect invasion of the dorsal cortex by the screws. In case of no protrusion, the patient will be registered as a correct fixation. Otherwise, it will be specified which position of the plate and which compartment the screw/s protrude. A screw with a correct measurement will then be replaced and implanted and recorded as a measurement error.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Screw protrusion | Perform an ultrasound of each dorsal compartment of the operated wrist | Intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Surgical time | Measure the additional surgical time involved in ultrasound view | Intraoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Distal radius volar fixation, Intraoperative ultrasound, screw protrusion detection