Snoddy Mark C, An Thomas J, Hooe Benjamin S, Kay Harrison F, Lee Donald H, Pappas Nick D
Vanderbilt Orthopaedic Institute, Vanderbilt University, Nashville, TN; Louisiana State University School of Medicine, New Orleans, LA.
Vanderbilt Orthopaedic Institute, Vanderbilt University, Nashville, TN; Louisiana State University School of Medicine, New Orleans, LA.
J Hand Surg Am. 2015 Mar;40(3):505-7. doi: 10.1016/j.jhsa.2014.11.022. Epub 2015 Jan 22.
To determine the incidence and reasons for hardware removal after operative fixation of distal radius fractures.
We retrospectively reviewed 33 patients who underwent removal of a volar distal radius plate from 2007 to 2013. We recorded the primary reason for plate removal, patient sex, body mass index, AO fracture type, and plate manufacturer. The total number of both distal radius plating procedures and implant removals was analyzed.
Of the 33 patients who underwent implant removal, the most common reasons for removal were pain (30%), tenosynovitis (27%), malunion (24%), infection (12%), nonunion (6%), and tendon rupture (3%). The most common AO fracture types requiring plate removal were A2, C2, and C3 (7 each). A total of 517 distal radius fractures received plate fixation at our institution from 2007 to 2009, a number that rose to 610 from 2010 to 2012. The number of distal radius plate removals over that same time was relatively constant at 17 and 16, respectively.
We advise continued review of reasons for implant removal to limit future hardware complications related to volar plating of distal radius fractures.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
确定桡骨远端骨折手术固定后内固定取出的发生率及原因。
我们回顾性分析了2007年至2013年间33例行桡骨远端掌侧钢板取出术的患者。记录钢板取出的主要原因、患者性别、体重指数、AO骨折类型及钢板制造商。分析桡骨远端钢板固定手术及植入物取出的总数。
在33例行植入物取出术的患者中，最常见的取出原因是疼痛（30%）、腱鞘炎（27%）、骨不连（24%）、感染（12%）、骨不愈合（6%）和肌腱断裂（3%）。需要取出钢板的最常见AO骨折类型为A2、C2和C3（各7例）。2007年至2009年，我院共有517例桡骨远端骨折接受钢板固定，2010年至2012年这一数字增至610例。同期桡骨远端钢板取出的数量相对稳定，分别为17例和16例。
我们建议持续评估植入物取出的原因，以减少未来与桡骨远端骨折掌侧钢板固定相关的内固定并发症。
研究类型/证据水平：治疗性IV级。
