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桡骨远端骨折掌侧钢板固定术后旋前方肌修复的前瞻性评估

Prospective evaluation of pronator quadratus repair following volar plate fixation of distal radius fractures.

作者信息

Tosti Rick, Ilyas Asif M

机构信息

Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA.

出版信息

J Hand Surg Am. 2013 Sep;38(9):1678-84. doi: 10.1016/j.jhsa.2013.06.006. Epub 2013 Aug 2.

Abstract

PURPOSE

To evaluate the efficacy of pronator quadratus (PQ) repair after volar plating of distal radius fractures.

METHODS

All consecutive distal radius fractures treated operatively with a volar plate during a 1-year period were assigned to receive a repair of the PQ versus no repair. Surgical exposure, reduction, and postoperative rehabilitation were equivalent in both groups. Clinical outcomes with a minimum follow-up of 12 months were assessed via range of motion; grip strength; Disabilities of the Arm, Shoulder, and Hand (DASH) scores; and visual analog scale (VAS) scores.

RESULTS

A total of 60 consecutive distal radius fractures were treated operatively with a locking volar plate. Full follow-up data were available for 33 patients in the PQ repair group and 24 patients in the control group. At 12 months, the mean DASH score was 8 for the repair group and 5 for the control group. Range of motion at the wrist, grip strength, and VAS scores were also not significantly different between groups. In addition, we found no significant differences in any of the parameters at the 2-, 6-, or 12-week intervals, although we observed greater grip strength and wrist flexion in the repair group at 6 weeks. Reoperation was required for 4 patients in the repair group and 1 in the control group.

CONCLUSIONS

Pronator quadratus repair after volar plating of a distal radius fractures did not significantly improve postoperative range of motion, grip strength, or DASH and VAS scores at 1 year. The rates of reoperation between groups were not significantly different.

摘要

目的

评估桡骨远端骨折掌侧钢板固定术后旋前方肌(PQ)修复的疗效。

方法

将1年内所有采用掌侧钢板手术治疗的连续性桡骨远端骨折患者分为PQ修复组和非修复组。两组的手术暴露、复位及术后康复情况相同。通过活动范围、握力、手臂、肩部和手部功能障碍(DASH)评分以及视觉模拟量表(VAS)评分评估至少随访12个月的临床结果。

结果

共有60例连续性桡骨远端骨折采用锁定掌侧钢板进行手术治疗。PQ修复组33例患者和对照组24例患者获得了完整的随访数据。12个月时,修复组的平均DASH评分为8分,对照组为5分。两组之间的腕关节活动范围、握力和VAS评分也无显著差异。此外,尽管我们观察到修复组在6周时握力和腕关节屈曲度更大,但在2周、6周或12周时,任何参数均无显著差异。修复组有4例患者需要再次手术,对照组有1例患者需要再次手术。

结论

桡骨远端骨折掌侧钢板固定术后旋前方肌修复在1年时并未显著改善术后活动范围、握力或DASH及VAS评分。两组之间的再次手术率无显著差异。

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