Kotian Prem, Mudiganty Srikanth, Annappa Rajendra, Austine Jose
Professor, Department of Orthopaedic Surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
Senior Resident, Department of Orthopaedic Surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .
J Clin Diagn Res. 2017 Jan;11(1):RC09-RC12. doi: 10.7860/JCDR/2017/24773.9282. Epub 2017 Jan 1.
Distal radius fractures accounts for around 15% of all fractures diagnosed and treated in the emergency rooms. These fractures usually result secondary to high velocity injury such as a motor vehicle accident or fall on an out stretched hand. In the elderly, it is a common fragility fracture. Volar Locking Compression Plates (LCP) is effective devices for fixation of the distal radius fractures. There is a lacuna with regard to literature on the 2.7 mm volar LCP and the current study retrospectively assesses the postoperative radiological outcomes.
To measure the radiological outcomes in patients with displaced distal radius fractures managed with 2.7 mm volar LCP fixation using Sarmiento's Modification of Lindstorm Criteria.
A retrospective study was conducted in the Department of Orthopaedic Surgery at Kasturba Medical College Allied Hospitals, Mangalore from May 2014 to July 2016. All displaced distal radius fractures of skeletally mature patients who underwent volar locking plate fixation between May 2014 to July 2016 and follow up with X-rays at six weeks and three months were included as part of the study. The study comprised of 20 patients and fractures were classified using the AO and Melone's classification systems. The radiological outcome was scored based on Sarmiento's Modification of Lindstorm Criteria.
Post operative check X-rays were analysed at immediate post operative, six weeks and three months. The mean immediate post operative radial shortening, decrease in radial deviation and loss of palmar tilt were 4.08±2.23, 5.91±4.01and 4.11±3.29 respectively. The corresponding values at last follow up were 4.71±2.31, 7.9±5.13 and 4.91±3.32 respectively. No statistically significant difference (p=0.930;874;716) in radial shortening, decrease in palmar angulation and loss of radial deviation was seen till the final follow up. Sarmiento's Modification of Lindstorm Criteria showed a good radiological outcome in 60% followed by fair in 25% and excellent in 15%.
Use of 2.7 mm volar LCP showed good to excellent post operative radiological outcomes in majority of the cases. The fracture reduction achieved in the immediate post operative period is maintained throughout the follow up duration.
桡骨远端骨折约占急诊室诊断和治疗的所有骨折的15%。这些骨折通常继发于高速损伤，如机动车事故或伸手撑地摔倒。在老年人中，这是一种常见的脆性骨折。掌侧锁定加压钢板（LCP）是治疗桡骨远端骨折的有效器械。关于2.7mm掌侧LCP的文献存在空白，本研究回顾性评估其术后影像学结果。
使用Sarmiento对Lindstorm标准的改良方法，测量采用2.7mm掌侧LCP固定的桡骨远端移位骨折患者的影像学结果。
2014年5月至2016年7月在芒格洛尔卡斯图尔巴医学院附属医院骨科进行了一项回顾性研究。纳入2014年5月至2016年7月期间接受掌侧锁定钢板固定且在六周和三个月时进行X线随访的所有骨骼成熟患者的桡骨远端移位骨折。该研究包括20例患者，骨折采用AO和Melone分类系统进行分类。影像学结果根据Sarmiento对Lindstorm标准的改良方法进行评分。
对术后即刻、六周和三个月时的术后复查X线片进行分析。术后即刻桡骨缩短、桡偏减小和掌倾角丢失的平均值分别为4.08±2.23、5.91±4.01和4.11±3.29。末次随访时的相应值分别为4.71±2.31、7.9±5.13和4.91±3.32。直至最终随访，桡骨缩短、掌倾角减小和桡偏丢失均无统计学显著差异（p=0.930；0.874；0.716）。Sarmiento对Lindstorm标准的改良方法显示，60%的患者影像学结果良好，25%为中等，15%为优秀。
在大多数病例中，使用2.7mm掌侧LCP显示出良好至优秀的术后影像学结果。术后即刻实现的骨折复位在整个随访期间得以维持。
