旋前方肌修复对桡骨远端骨折掌侧钢板固定术后结果的影响。
The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures.
机构信息
Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, NY 10003, USA.
出版信息
J Orthop Trauma. 2013 Mar;27(3):130-3. doi: 10.1097/BOT.0b013e3182539333.
OBJECTIVES
The purpose of this study was to evaluate forearm rotation after volar plating of the distal radius fractures with and without pronator quadratus repair.
DESIGN
This was an institutional review board-approved retrospective review of prospectively collected data.
SETTING
The study was conducted at an Academic Medical Center.
PATIENTS
Over a 5-year period, 606 patients with distal radius fractures (OTA classifications 23-A through 23-C) were enrolled in an institutional review board-approved, prospectively collected, distal radius database. One hundred and seventy-five patients underwent open reduction and internal fixation with volar plating. Of these, 112 patients had complete 1-year follow-up (6 weeks, 3, 6, and 12 months) and were included in this study.
INTERVENTION
Volar plating of the distal radius was performed with pronator quadratus repair (group A), versus volar plating without pronator quadratus repair (group B). Surgeries in group A were performed by a fellowship trained hand surgeon utilizing volar plates from Depuy Orthopedics (Warsaw, IN), whereas the surgeries in group B were performed by a fellowship trained orthopedic trauma surgeon utilizing volar plates from Stryker (Mahwah, NJ).
MAIN OUTCOME MEASUREMENTS
Primary outcomes include forearm range of motion. Secondary outcomes include grip strength, pain levels, functional outcomes (DASH scores), radiographs, and complications.
RESULTS
Baseline and demographic characteristics of the patients were similar between the 2 groups. There was no difference in mean pronation (P = 0.08) at 1 year. Among secondary analyses, radial deviation was significantly different (P = 0.03); however, pain (P = 0.13) and DASH scores (P = 0.14) were not. The only patient that requested plate removal had the pronator repaired (group A).
CONCLUSIONS
We conclude that there is no advantage in repairing the pronator quadratus during volar plating of distal radius fractures.
LEVEL OF EVIDENCE
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
目的
本研究旨在评估桡骨远端骨折掌侧钢板固定时是否修复旋前方肌对前臂旋转的影响。
设计
这是一项机构审查委员会批准的前瞻性数据回顾性研究。
设置
该研究在一家学术医疗中心进行。
患者
在 5 年期间，606 例桡骨远端骨折（OTA 分类 23-A 至 23-C）患者纳入机构审查委员会批准的前瞻性桡骨远端数据库。其中 175 例行切开复位内固定掌侧钢板固定。其中 112 例患者获得完整 1 年随访（6 周、3、6 和 12 个月），并纳入本研究。
干预
桡骨远端掌侧钢板固定时修复旋前方肌（A 组），不修复旋前方肌（B 组）。A 组手术由经过 fellowship 培训的手外科医生使用 Depuy Orthopedics（Warsaw，IN）的掌侧钢板进行，B 组手术由经过 fellowship 培训的骨科创伤外科医生使用 Stryker（Mahwah，NJ）的掌侧钢板进行。
主要观察指标
主要结果包括前臂活动范围。次要结果包括握力、疼痛程度、功能结果（DASH 评分）、影像学和并发症。
结果
两组患者的基线和人口统计学特征相似。1 年时平均旋前度无差异（P = 0.08）。在次要分析中，桡偏明显不同（P = 0.03）；然而，疼痛（P = 0.13）和 DASH 评分（P = 0.14）无差异。唯一要求取出钢板的患者接受了旋前方肌修复（A 组）。
结论
我们得出结论，在桡骨远端骨折掌侧钢板固定时修复旋前方肌没有优势。
证据水平
治疗性 III 级。有关证据水平的完整描述，请参阅作者指南。
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