Hoffmann Jeffrey D, Stewart Jeremy, Kusnezov Nicholas, Dunn John, Pirela-Cruz Miguel
1 Texas Tech University Health Sciences Center, Lubbock, USA.
2 William Beaumont Army Medical Center, El Paso, TX, USA.
Hand (N Y). 2017 Sep;12(5):471-475. doi: 10.1177/1558944716669136. Epub 2016 Oct 22.
Distal radius fractures represent a common fracture pattern frequently treated with volar locked plating for fixation. However, other methods may provide equivalent outcomes and minimize risks associated with the volar approach and hardware placement. One such method is the radial plate.
After confirmation of institutional board review, we retrospectively reviewed data from 7 patients with our primary functional outcomes measured by Mayo wrist and Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores. The most recent radiographic and motion parameters were recorded.
Mean age at time of injury was 49 years (range, 19-68 years) with clinical follow-up of 81.6 months (range, 43.5-95.5 months). Five patients had good to excellent outcomes with a mean QuickDASH score of 0.92 for those patients. The mean QuickDASH score for all patients was 18.5. Mean radial height, inclination, and volar tilt were within 5% of the contralateral side. Standard deviation values for radiographic measures and clinical range of motion indicate significant variability in our data set.
Although the results are mixed, our small cohort indicates radial plate fixation could provide a viable alternative to volar plate fixation of distal radius fractures. Further prospective investigation is warranted to better describe long-term outcomes using this technique.
桡骨远端骨折是一种常见的骨折类型,常采用掌侧锁定钢板进行固定治疗。然而,其他方法可能会带来同等的治疗效果,并将与掌侧入路及硬件植入相关的风险降至最低。其中一种方法就是桡侧钢板。
在获得机构审查委员会批准后,我们回顾性分析了7例患者的数据,主要功能转归通过梅奥腕关节评分及上肢、肩部和手部功能障碍(QuickDASH)评分进行衡量。记录了最新的影像学和活动参数。
受伤时的平均年龄为49岁(范围19 - 68岁),临床随访时间为81.6个月(范围43.5 - 95.5个月)。5例患者获得了良好至优秀的治疗效果,这些患者的平均QuickDASH评分为0.92。所有患者的平均QuickDASH评分为18.5。桡骨的平均高度、倾斜度和掌侧倾斜度与对侧相比在5%以内。影像学测量的标准差数值及临床活动范围表明我们的数据集中存在显著变异性。
尽管结果不一,但我们的小样本队列表明,桡侧钢板固定对于桡骨远端骨折来说可能是掌侧钢板固定的一种可行替代方法。有必要进行进一步的前瞻性研究,以更好地描述使用该技术的长期疗效。