The Value of Calibration of Radiographs in Total Wrist Arthroplasty

Description

In this presentation, Henry Crouch-Smith discusses the importance of radiographic calibration in preoperative templating for total wrist arthroplasty. He begins by outlining the historic background of total wrist arthroplasty, which dates back to the 1800s and highlights the evolution of techniques and implants used in the procedure. Crouch-Smith specifically mentions the use of the Motec implant at Liverpool University Hospital, emphasizing that accurate sizing is crucial to prevent complications such as loosening or fracture of the prosthesis.



The speaker explains various templating methods, including traditional overlay techniques and modern digital approaches, and refers to studies showing significant variances in size selection for lower limb arthroplasties, often due to magnification issues during radiographic imaging. This leads to the exploration of calibrating radiographs as a potential solution to ensure more accurate measurements prior to surgery.



Through a prospective study involving patients from a regional hand unit, the team generated data comparing calibrated and uncalibrated radiographs. Remarkably, results indicated no statistically significant differences between the two methods. Crouch-Smith concludes that radiographic calibration is unnecessary for routine hand and wrist radiographs in preoperative templating, rationalizing that the close proximity of the hand or wrist to the X-ray plate minimizes magnification concerns as compared to areas further within the body. The session closes with a short Q&A, wherein the audience engages with the topic, exploring the implications of the findings on clinical practice.

DOI: 10.1302/3114-221345

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