Makhni E C, Taghinia A, Ewald T, Zurakowski D, Day C S
Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
J Hand Surg Eur Vol. 2010 Oct;35(8):652-8. doi: 10.1177/1753193409338750. Epub 2010 Mar 17.
Comminution of the dorsal metaphysis is a relatively common feature of distal radius fractures. However, its effects on the radiographic outcomes of these fractures are not entirely understood. One hundred and twenty-four conservatively managed distal radius fractures were analysed retrospectively to assess the effect of dorsal metaphyseal comminution on fracture stability, especially with respect to initial displacement (minimally displaced versus displaced) and age group. Seventy-seven fractures (62%) had radiographic evidence of dorsal comminution. The secondary displacement rate of these fractures was 75%, compared to 45% in non-comminuted counterparts (P<0.001). In minimally displaced fractures, the secondary displacement rate was higher in those with dorsal comminution as compared to those without (57% vs. 31%, P=0.086). Dorsal metaphyseal comminution was found in 75% of fractures in patients 65+years old (P=0.05). Among those with dorsal comminution, the secondary displacement rates were similar for both men and women (63% vs. 79%; P=0.20). In conclusion, distal radius fractures with dorsal metaphyseal comminution had significantly higher rates of secondary displacement compared to non-comminuted counterparts, and there exists a correlation with this displacement and increasing patient age but not gender.
桡骨远端干骺端粉碎是桡骨远端骨折相对常见的特征。然而，其对这些骨折影像学结果的影响尚未完全明确。对124例采用保守治疗的桡骨远端骨折进行回顾性分析，以评估背侧干骺端粉碎对骨折稳定性的影响，特别是在初始移位（轻度移位与移位）和年龄组方面。77例骨折（62%）有背侧粉碎的影像学证据。这些骨折的二次移位率为75%，而未粉碎骨折的二次移位率为45%（P<0.001）。在轻度移位骨折中，有背侧粉碎的骨折二次移位率高于无背侧粉碎的骨折（57%对31%，P=0.086）。65岁及以上患者的骨折中有75%存在背侧干骺端粉碎（P=0.05）。在有背侧粉碎的患者中，男性和女性的二次移位率相似（63%对79%；P=0.20）。总之，与未粉碎的桡骨远端骨折相比，伴有背侧干骺端粉碎的桡骨远端骨折二次移位率明显更高，且这种移位与患者年龄增加相关，与性别无关。
