Satake Hiroshi, Hanaka Naomi, Honma Ryusuke, Watanabe Tadayoshi, Inoue Shigeru, Kanauchi Yumiko, Kato Yoshihiro, Nakajima Taku, Sato Daisuke, Eto Jun, Maruyama Masahiro, Naganuma Yasushi, Sasaki Junya, Toyono Shuji, Harada Mikio, Ishigaki Daisuke, Takahara Masatoshi, Takagi Michiaki
Orthopedics. 2016 Sep 1;39(5):e893-6. doi: 10.3928/01477447-20160517-05. Epub 2016 May 25.
The current study investigated the incidence of complications after surgery for distal radial fractures. This multicenter retrospective study was conducted at 11 institutions. A total of 824 patients who had distal radius fractures that were treated surgically between January 2010 and August 2012 were identified. The study patients were older than 18 years and were observed for at least 12 weeks after surgery for distal radius fractures with a volar locking plate. Sex, age, fracture type according to AO classification, implants, wrist range of motion, grip strength, fracture consolidation rate, and complications were studied. Analysis included 694 patients, including 529 women and 165 men, with a mean age of 64 years. The mean follow-up period was 27 weeks. The fracture consolidation rate was 100%. There were 52 complications (7.5%), including 18 cases of carpal tunnel syndrome, 12 cases of peripheral nerve palsy, 8 cases of trigger digit, 4 cases of tendon rupture (none of the flexor pollicis longus), and 10 others. There was no rupture of the flexor pollicis longus tendon because careful attention was paid to the relationship between the implant and the tendon. Peripheral nerve palsy may have been caused by intraoperative traction in 7 cases, temporary fixation by percutaneous Kirschner wires in 3 cases, and axillary nerve block in 1 case; 1 case appeared to be idiopathic. Tendon ruptures were mainly caused by mechanical stress. [Orthopedics.2016; 39(5):e893-e896.].
本研究调查了桡骨远端骨折术后并发症的发生率。这项多中心回顾性研究在11家机构开展。共确定了824例于2010年1月至2012年8月接受手术治疗的桡骨远端骨折患者。研究患者年龄大于18岁，接受掌侧锁定钢板治疗桡骨远端骨折术后至少观察12周。对性别、年龄、AO分类的骨折类型、植入物、腕关节活动范围、握力、骨折愈合率及并发症进行了研究。分析纳入694例患者，其中包括529例女性和165例男性，平均年龄64岁。平均随访期为27周。骨折愈合率为100%。有52例并发症（7.5%），包括18例腕管综合征、12例周围神经麻痹、8例扳机指、4例肌腱断裂（均非拇长屈肌腱）及其他10例。未发生拇长屈肌腱断裂，因为对植入物与肌腱之间的关系给予了密切关注。7例周围神经麻痹可能由术中牵拉引起，3例由经皮克氏针临时固定引起，1例由腋神经阻滞引起；1例似乎为特发性。肌腱断裂主要由机械应力所致。[《骨科学》.2016；39(5):e893 - e896。]
