Beumer Annechien, McQueen Margaret M
Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, 1 Lauriston Place, Edinburgh EH3 9YW, Scotland.
Acta Orthop Scand. 2003 Feb;74(1):98-100. doi: 10.1080/00016470310013743.
To determine the value of reduction of fractures of the distal radius in the very elderly and low-demand or demented patient, we assessed 60 fractures in 59 patients for the reduction achieved and maintained. The mean patient age was 82 (65-93) years. All fractures were initially reduced under regional or general anaesthesia. In 44 dorsally displaced fractures, reduction failed in 7 cases initially, and 37 lost reduction during the following weeks of immobilisation in plaster. In 9 wrists with volarly displaced fractures, reduction was achieved in 6; all malunited. A total of 53/60 fractures healed in a malunited position. We found no correlation between fracture classification, initial displacement, and final radiographical outcome. On the basis of these observations we conclude that reduction of fractures of the distal radius is of minimal value in the very old and frail, dependent or demented patient.
为确定在高龄、低需求或患有痴呆症的患者中桡骨远端骨折复位的价值，我们评估了59例患者的60处骨折的复位情况及复位维持情况。患者平均年龄为82（65 - 93）岁。所有骨折最初均在区域麻醉或全身麻醉下进行复位。在44例背侧移位骨折中，7例最初复位失败，37例在随后几周的石膏固定期间复位丢失。在9例掌侧移位骨折的腕关节中，6例实现了复位；均发生了畸形愈合。60处骨折中共有53处畸形愈合。我们发现骨折分类、初始移位与最终影像学结果之间无相关性。基于这些观察结果，我们得出结论，在高龄、体弱、依赖他人或患有痴呆症的患者中，桡骨远端骨折复位的价值极小。
