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术后X线片在AO型桡骨远端骨折临床治疗中的价值

The value of post-operative radiographs in clinical management of AO type A distal radius fractures.

作者信息

Huffaker S, Earp B E, Blazar P E

机构信息

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston MA, USA.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston MA, USA

出版信息

J Hand Surg Eur Vol. 2015 Oct;40(8):790-5. doi: 10.1177/1753193414562354. Epub 2014 Dec 16.

Abstract

The value of post-operative radiographs following stabilization of Arbeitsgemeinschaft für Osteosynthesefragen (AO) type A distal radius fractures with volar locking plates is unclear. We examined the value of post-operative radiographs of type A fractures treated with volar locking plates. A retrospective review was performed on all AO type A distal radius fractures treated with volar locking plates between 2007 and 2010 at two institutions. A total of 158 patients receiving 446 sets of post-operative radiographs were included. Reviewing all clinic, emergency, and operative notes, we found that 94% of radiographs were performed as routine follow-up, with no set of post-operative radiographs demonstrating findings of hardware/fracture site complications. All cases requiring further workup or interventions were heralded by patient complaints. Routine post-operative radiographs following volar locking plates for extra-articular distal radius fractures did not demonstrably alter clinical decision making; this is an area where a reduction in resource utilization would not seem to alter clinical quality care, but further studies with larger populations are needed to establish the incidence of radiographic problems prior to symptom occurrence. Level of evidence: Diagnostic III.

摘要

使用掌侧锁定钢板固定AO分型A类桡骨远端骨折后术后X线片的价值尚不清楚。我们研究了使用掌侧锁定钢板治疗A类骨折术后X线片的价值。对2007年至2010年期间在两家机构接受掌侧锁定钢板治疗的所有AO分型A类桡骨远端骨折进行了回顾性研究。共纳入158例患者,获得446组术后X线片。通过查阅所有临床、急诊和手术记录,我们发现94%的X线片是作为常规随访进行的,没有一组术后X线片显示有内固定物/骨折部位并发症的表现。所有需要进一步检查或干预的病例均由患者主诉预示。对于关节外桡骨远端骨折使用掌侧锁定钢板后的常规术后X线片并未明显改变临床决策;在这方面,资源利用的减少似乎不会改变临床优质护理,但需要对更多人群进行进一步研究,以确定症状出现前影像学问题的发生率。证据级别:诊断性III级。

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