Kaufman Adam M, Pensy Raymond A, O'Toole Robert V, Eglseder W Andrew
R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Injury. 2014 Mar;45(3):534-9. doi: 10.1016/j.injury.2013.10.006. Epub 2013 Oct 15.
There is a paucity of literature regarding outcomes of open fractures of the distal radius. No study has detailed this injury or treatment strategy in the geriatric population. The purpose of this study was to determine the safety of immediate open reduction and internal fixation of geriatric open fractures of the distal radius.
A total of 21 geriatric patients with open fractures of the distal radius treated with a single definitive procedure were identified from a prospectively collected database. We reviewed patient demographics, injury characteristics and treatment specifics. Our primary outcome was surgical-site infection defined by need for antibiotics or repeat surgery. Our secondary outcome was need for other re-operation. Patients were contacted and functional scores obtained.
Patients were followed up for an average of 26 months. One deep infection and one nonunion occurred, and they required repeat surgery. Four minor operative complications occurred, including stiffness requiring manipulation and prominent fixation devices requiring removal. Patients maintained an average wrist flexion-extension arc of 89° and pronation-supination arc of 137°. The average QuickDASH (shortened disabilities of the arm, shoulder and hand questionnaire) score was 17.4, indicating minimal disability of the upper extremity.
Immediate open reduction and internal fixation of geriatric open fractures of the distal radius yields adequate functional results with low risk of major complications.
关于桡骨远端开放性骨折的治疗结果,相关文献较少。尚无研究详细阐述老年人群中的此类损伤及治疗策略。本研究的目的是确定老年桡骨远端开放性骨折一期切开复位内固定术的安全性。
从一个前瞻性收集的数据库中,确定了21例接受单一确定性手术治疗的老年桡骨远端开放性骨折患者。我们回顾了患者的人口统计学资料、损伤特征和治疗细节。我们的主要结局是手术部位感染,定义为需要使用抗生素或再次手术。次要结局是需要进行其他再次手术。对患者进行了随访并获得了功能评分。
患者平均随访26个月。发生了1例深部感染和1例骨不连,均需要再次手术。发生了4例轻微手术并发症,包括需要手法治疗的僵硬和需要取出的突出固定装置。患者的平均腕关节屈伸弧为89°,旋前旋后弧为137°。平均QuickDASH(上肢、肩部和手部功能障碍简化问卷)评分为17.4,表明上肢功能障碍极小。
老年桡骨远端开放性骨折一期切开复位内固定术能产生足够的功能结果,且主要并发症风险较低。