Chen Alvin Chao-Yu, Cheng Chun-Ying, Chou Ying-Chao
Bone and Joint Research Center, Chang Gung Memorial Hospital-Linkou & University College of Medicine, 5th, Fu-Shin St., Kweishan Dist, Taoyuan, 333, Taiwan, ROC.
J Orthop Traumatol. 2017 Mar;18(1):37-42. doi: 10.1007/s10195-016-0422-y. Epub 2016 Jul 26.
Post-traumatic deformity of the distal radius may lead to multiple sequelae and severe functional impairment. Intramedullary fixation is a novel technique for treatment of distal radius fractures. The present study aimed to evaluate the functional and radiographic outcomes of intramedullary nailing for correction of post-traumatic deformity in late-diagnosed fractures of the distal radius.
From July 2009 to February 2011, 16 patients with late-diagnosed displaced fractures of the distal radius were included. Eligible inclusion was extra-articular fracture for more than 4 weeks. Surgical correction and internal fixation with intramedullary nailing was performed for treatment of ten AO type A2 and six AO type A3 fractures. All patients were followed up radiographically and clinically for an average of 20.3 months.
All fractures achieved bone union without major complications. Functional status and radiographic alignment significantly improved postoperatively. There was no significantly secondary displacement comparing early postoperative and final radiographic parameters. The functional results according to the Mayo wrist scoring system were good or excellent in 94 % of patients. The mean score was 83.8.
Surgical correction and internal fixation with the intramedullary nail is a feasible and less invasive technique with few complications in the treatment of post-traumatic deformity of the distal radius.
IV.
桡骨远端创伤后畸形可能导致多种后遗症和严重功能障碍。髓内固定是治疗桡骨远端骨折的一种新技术。本研究旨在评估髓内钉固定矫正桡骨远端延迟诊断骨折创伤后畸形的功能和影像学结果。
纳入2009年7月至2011年2月间16例桡骨远端延迟诊断的移位骨折患者。纳入标准为关节外骨折超过4周。对10例AO A2型和6例AO A3型骨折采用手术矫正并髓内钉内固定治疗。所有患者均接受平均20.3个月的影像学和临床随访。
所有骨折均实现骨愈合,无重大并发症。术后功能状态和影像学对线显著改善。术后早期与最终影像学参数相比,无明显二次移位。根据Mayo腕关节评分系统,94%的患者功能结果为良好或优秀。平均评分为83.8。
髓内钉手术矫正和内固定是治疗桡骨远端创伤后畸形的一种可行且侵入性较小的技术,并发症较少。
IV级。