Department of Orthopedic Surgery, Ewha Womans University School of Medicine, Ewha Womans University Medical Center, Seoul, Korea.
Clin Orthop Relat Res. 2013 Jun;471(6):2030-5. doi: 10.1007/s11999-013-2798-9. Epub 2013 Jan 24.
Low-grade (Gustilo and Anderson Type I or II) open distal radius fractures (DRFs) have been treated by volar locking plate fixation. However, it is unclear whether the outcomes after volar locking plate fixation for low-grade open DRFs are comparable to those for closed DRFs.
QUESTIONS/PURPOSES: We asked whether low-grade open DRFs had worse DASH scores and higher infection rates than closed DRFs when the DRFs were treated by volar plate fixation.
Twenty consecutive patients treated by volar locking plate fixation for low-grade open DRFs constituted the open fracture group, and 40 patients were selected from among the total number of patients treated by volar, locking plate fixation for closed DRFs as the closed fracture group. Complications including infection were recorded. Clinical outcomes and radiographic assessments were performed postoperatively at 3 months and 1 year.
At 3 postoperative months, wrist flexion and extension, grip strengths, and DASH scores were better in the closed fracture group; however, no difference was observed postoperatively between the two groups in terms of any functional outcome measure at 1 year. Any of the radiographic parameters were not different between the groups. There were no differences in infection rate and in any other complication rate between the groups.
Although functional outcomes of open DRFs were inferior to those of closed DRFs at 3 months, at 1 year, outcomes of low-grade open DRFs were found to be comparable to those of closed DRFs when volar plate fixation was used.
低等级(Gustilo 和 Anderson 类型 I 或 II)开放性桡骨远端骨折(DRF)已通过掌侧锁定板固定治疗。然而,对于低等级开放性 DRF 通过掌侧锁定板固定的治疗效果是否与闭合性 DRF 相当尚不清楚。
问题/目的:我们询问了在通过掌侧板固定治疗低等级开放性 DRF 时,低等级开放性 DRF 的 DASH 评分是否比闭合性 DRF 更差,感染率是否更高。
连续 20 例采用掌侧锁定板固定治疗低等级开放性 DRF 的患者构成开放性骨折组,从采用掌侧、锁定板固定治疗闭合性 DRF 的患者中选择 40 例作为闭合性骨折组。记录并发症,包括感染。术后 3 个月和 1 年进行临床结果和影像学评估。
术后 3 个月时,闭合性骨折组的腕关节屈伸、握力和 DASH 评分更好;然而,在 1 年时,两组在任何功能测量结果方面均无差异。两组之间的任何影像学参数均无差异。两组之间的感染率和任何其他并发症率均无差异。
尽管开放性 DRF 的功能结果在 3 个月时劣于闭合性 DRF,但在使用掌侧板固定时,低等级开放性 DRF 的结果在 1 年时被发现与闭合性 DRF 相当。