Dicpinigaitis Paul, Wolinsky Philip, Hiebert Rudi, Egol Kenneth, Koval Kenneth, Tejwani Nirmal
New York University Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10016, USA.
J Trauma. 2004 Oct;57(4):845-50. doi: 10.1097/01.ta.0000106290.49252.20.
The purpose of this study was to assess the effectiveness of external fixation and percutaneous pinning in maintaining distal radius fracture reduction over a 6-month period and to identify factors that might predict loss of fracture reduction.
Seventy cases had complete radiographic evaluation before surgery; at surgery; and at 6-week, 3-month, and 6-month follow-up. Radiographic parameters measured included volar tilt, dorsal displacement, radial inclination, radial height, radial shift, and ulnar variance.
Dorsal tilt averaged 17.5 degrees from neutral before surgery; this value was corrected to 0.9 degree at surgery, but then progressed to 4.2 degrees by the 6-month follow-up. At 6-month follow-up, 49% of cases had lost more than 5 degrees of initially reduced volar tilt. However, none of these patients went from an acceptable initial reduction to an unacceptable reduction at 6 months. Initial deformity, patient age, use of bone graft, and duration of external fixation were not predictors of loss of reduction.
Loss of reduction of volar tilt was seen for a period of up to 6 months after fixation, despite the use of pinning to hold the reduction. No specific predictor of loss of reduction was noted, although there was a trend toward loss of reduction in younger patients.
本研究的目的是评估外固定和经皮穿针在维持桡骨远端骨折复位6个月期间的有效性，并确定可能预测骨折复位丢失的因素。
70例患者在手术前、手术时以及术后6周、3个月和6个月进行了完整的影像学评估。测量的影像学参数包括掌倾角、背侧移位、桡骨倾斜度、桡骨高度、桡骨移位和尺骨变异。
术前背倾角平均偏离中立位17.5度；手术时该值矫正至0.9度，但到6个月随访时进展至4.2度。在6个月随访时，49%的病例最初复位的掌倾角丢失超过5度。然而，这些患者在6个月时均未从可接受的初始复位变为不可接受的复位。初始畸形、患者年龄、植骨的使用以及外固定时间均不是复位丢失的预测因素。
尽管使用穿针维持复位，但在固定后长达6个月的时间内仍可见掌倾角复位丢失。未发现复位丢失的特定预测因素，尽管年轻患者有复位丢失的趋势。
