Screw direction

Question 1

Barnes VS 2014

Defining entry and exit point

Answer 1

Medial -> lateral higher risk of penetrating joint

Question 2

Chase VS 2019

Retrospective 26 transcondylar screws for HIF
All lateral -> medial

Answer 2

!! 70% complication rate (42% SSI)
No risk factors for SSI
SSI 28x more likely to have unsatisfactory long term outcome

Question 3

**Potamopoulou VCOT 2023
**Nonrandomised retrospective
Min F/U 3 months

ML vs LM affect SSI

45 positional, 1 lag, 2 plate augmentation

Answer 3

LM higher rate of SSI but not sig different (27% vs 23%)
44% that had bilateral single sx developed unilateral SSI

Question 4

**Carwardine VS 2023
**Randomized, prospective
73 elbows

ML vs LM
All positional

Answer 4

Overall 41% complications (20% ML, 60% LM)
- 40% seromas, 50% SSI
-13% rv sx

SSI: LM 30%, ML 10%

Small diameter implants higher risk of major complication
Screws should be placed ML