Zehir Sinan, Calbiyik Murat, Zehir Regayip, Ipek Deniz
Department of Orthopaedics and Traumatology, Hitit University Faculty of Medicine, Corum, Turkey,
Int Orthop. 2014 Aug;38(8):1655-60. doi: 10.1007/s00264-014-2382-2. Epub 2014 Jun 10.
This prospective randomized pilot study reports our institutional experience and early results using Sonoma Wrx (Sonoma Orthopedic Products, Santa Rosa, CA) in the treatment of extra-articular and simple intra-articular distal radius fractures.
A total of 64 patients, were enrolled in the study. They were considered eligible if they had; unstable extra-articular distal radius fractures and simple intra-articular distal radius fractures suitable for closed reduction (AO types; A2.2, A2.3, A3.1 C2.1, C2.2). Patients in group I received intramedullary fixation using the Sonoma Wrx device and patients in group II received standard volar locking plate fixation. Radiographic criteria of acceptable healing were used for evaluation.
Two groups were similar in terms of baseline characteristics. Mean time of operation was significantly shorter in Group 1 vs. in group 2 (36.81 ± 7.11 vs. 48.97 ± 5.9 minutes, p = 0.001). Time to healing of the fracture was not different between two groups (5.45 ± 1.09 vs. 5.70 ± 1.04 weeks for Group 1 vs. 2, respectively p = 0.36). Overall complications occurred in 9 patients in group 1 and in 15 patients in group 2 (p = 0.17). Follow-up was completed in all patients with a median time of 12 months and 13 months in group 1 and 2, respectively. On radiographic evaluation radial inclination, radial height and volar tilt were not significantly different between group 1 and 2, respectively. There were no significant differences between two groups in regard to wrist rotational degrees measured in last follow-up visit.
Sonoma Wrx Device is reliable and effective in terms of achieving satisfactory outcomes in treatment of distal radius fractures. It may be reasonable to use this device to prevent complications that are related to extensive soft tissue dissection.
本前瞻性随机试点研究报告了我们机构使用索诺玛Wrx(索诺玛骨科产品公司,加利福尼亚州圣罗莎)治疗桡骨远端关节外骨折和简单关节内骨折的经验及早期结果。
共有64例患者纳入本研究。若患者患有不稳定的桡骨远端关节外骨折和适合闭合复位的简单关节内桡骨远端骨折(AO分型:A2.2、A2.3、A3.1、C2.1、C2.2),则被认为符合入选标准。第一组患者使用索诺玛Wrx装置进行髓内固定,第二组患者接受标准掌侧锁定钢板固定。采用可接受愈合的影像学标准进行评估。
两组在基线特征方面相似。第一组的平均手术时间显著短于第二组(36.81±7.11分钟对48.97±5.9分钟,p = 0.001)。两组骨折愈合时间无差异(第一组与第二组分别为5.45±1.09周对5.70±1.04周,p = 0.36)。第一组有9例患者发生总体并发症,第二组有15例患者发生总体并发症(p = 0.17)。所有患者均完成随访,第一组和第二组的中位随访时间分别为12个月和13个月。影像学评估显示,第一组和第二组的桡骨倾斜度、桡骨高度和掌侧倾斜度分别无显著差异。在最后一次随访中测量的腕关节旋转度数两组之间无显著差异。
索诺玛Wrx装置在治疗桡骨远端骨折方面取得满意结果方面可靠且有效。使用该装置以预防与广泛软组织剥离相关的并发症可能是合理的。