title: Is it possible to avoid intra-articular screw penetration with minimal use of fluoroscopy in the application of distal radius volar plate?
abstract: OBJECTIVE
  This study aims to investigate whether or not it is possible to avoid intra-articular screw penetration in the application of distal radius volar plate with minimal use of fluoroscopy and thereby reduce to a minimum the risk of exposure of the surgical team to radiation.
  
  
  METHODS
  Volar plate with distal screw application with minimal use of fluoroscopy was performed in a total of 50 patients (22 males, 28 females; mean age 43.52 years; range 18 to 76 years) with unstable distal radius fracture following reduction of fracture between June 2014 and May 2016. A specially designed volar anatomic plate was applied by creating a 3 mm gap proximal from the tip of the facet of the lunate fossa.
  
  
  RESULTS
  No intra-articular screw complication was observed during plate-screw applications that we performed by using fluoroscopy at a minimum level and paying attention to the surgical technique described with the plate designed by giving a specific angle to screw beds. During the operation, fluoroscopy was performed at a minimum level and no finding was observed which could suggest use of intra-articular screw. No findings of restriction in wrist movements, locking or friction were observed intra- or postoperatively.
  
  
  CONCLUSIONS
  With improvements in the design of the volar plate and the distal locking screw bed, it is possible to rule out the possibility of intra-articular screw complications and the need for surgical re-correction in the early-term, and to reduce to a minimum the risk of exposure of the surgical team to radiation.
authors.affiliation: Department of Orthopedics and Traumatology, Sağlık Bilimleri University, Antalya Training and Research Hospital, 07030 Muratpaşa, Antalya, Turkey. aldemircengiz@yahoo.com.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Aldemir
authors.forename: Fatih
authors.initials: F
authors.lastname: Duygun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws / Q000009:adverse effects*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control*; D009985:Orthopedics / Q000379:methods*; D011183:Postoperative Complications; D000069079:Radiation Exposure / Q000517:prevention & control*; D011885:Radius Fractures / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery; D055815:Young Adult