Henry Mark H
Hand and Wrist Center of Houston, Houston, TX 77004, USA.
J Hand Surg Am. 2008 Sep;33(7):1215-27. doi: 10.1016/j.jhsa.2008.07.013.
Despite the frequency of distal radius fractures, studies in the existing literature have not been able to determine the optimal surgical strategies for various fracture patterns. Numerous clinical articles have been written, but most are level IV case series or expert opinion reviews. Good biomechanics studies have been published that suggest advantages of certain fixation methods over others. Transference of these expectations to clinical reality, however, requires well-controlled patient trials. In large part, this has not happened. This article reviews the theoretical pros and cons of different surgical strategies used for adult distal radius fractures, and then looks at randomized controlled trials that have been published in the last 5 years.
尽管桡骨远端骨折很常见,但现有文献中的研究仍未能确定针对各种骨折类型的最佳手术策略。已经撰写了大量临床文章,但大多数是IV级病例系列或专家意见综述。已经发表了一些很好的生物力学研究,表明某些固定方法比其他方法更具优势。然而,要将这些预期转化为临床实际情况,需要进行严格对照的患者试验。在很大程度上,这尚未实现。本文回顾了用于成人桡骨远端骨折的不同手术策略的理论优缺点,然后审视了过去5年发表的随机对照试验。