Di Maggio Bruno, Sessa Pasquale, Mantelli Patrizia, Maniscalco Pietro, Rivera Fabrizio, Calori Giorgio Maria, Bisogno Luigi, Scaravilli Gabriele, Caforio Marco
UOC ortopedia e Traumatologia Presidio Ospedaliero Piedimonte Matese (CE).
Orthopaedic Oncology Department - CTO, Roma.
Injury. 2017 Oct;48 Suppl 3:S34-S38. doi: 10.1016/S0020-1383(17)30655-1.
Open reduction and internal fixation (ORIF) with plate and screws represents the recommended treatment for unstable intra-articular distal radius fractures. Although significant progresses in surgical technique have been made, anatomical reconstruction of radio-carpal articular surface still represent a difficult task, especially in multifragmentary fractures. Available PEEK reinforced-carbon fiber composite radiolucent devices allow both an easier and more careful assessment of intra-operative reduction of the articular surface of distal radius and prompt correction of any residual step deformity.
We retrospectively reviewed clinical and radiological multicentre results of 71 consecutive AO B and C fracture pattern of distal radius treated using the same PEEK reinforced-carbon fiber composite radiolucent plate.
Three patients lost at final follow up and 4 cases with incomplete radiological documentations were excluded from the study. 64 patients (38 females, 26 males) were available and formed the basis of this report. Fracture types included 9 patients with 23-B, 13 patients 23-B2,15 patients with 23-B3,10 patients with 23-C1, 7 patients with 23-C2 and 10 patients with 23-C3. Mean Modified Mayo wrist Score was on average 38.11 (SD 10.1; range 24-75, 95%CI 34.7-41.4), 67.22 (SD 9.6, range 50-90, 95%CI 64-70.4), 90.54 (SD 6.3, range 75-100, 95%CI 88.4-92.6) at one, two and twelve months of follow-up, respectively. A statistically significant difference was found between mean scores at different follow-up periods (p = 0.001). We noted 1 case of distal screw fixation aseptic loosening at 5 months post surgical intervention.
PEEK reinforced-carbon fiber composite radiolucent plate represents a useful device for treatment of complex distal radius fractures in the adult population. It possesses unique biomechanical properties and allows for an easier anatomical reduction during surgical intervention.
采用钢板和螺钉进行切开复位内固定（ORIF）是不稳定型桡骨远端关节内骨折的推荐治疗方法。尽管手术技术取得了显著进展，但桡腕关节面的解剖重建仍然是一项艰巨的任务，尤其是在多片段骨折中。现有的聚醚醚酮（PEEK）增强碳纤维复合透射线装置有助于更轻松、更仔细地评估术中桡骨远端关节面的复位情况，并能迅速纠正任何残留的台阶畸形。
我们回顾性分析了71例连续采用同一PEEK增强碳纤维复合透射线钢板治疗的桡骨远端AO B型和C型骨折的多中心临床和影像学结果。
3例患者在最终随访时失访，4例影像学资料不完整的病例被排除在研究之外。64例患者（38例女性，26例男性）纳入研究并作为本报告的基础。骨折类型包括9例23-B型、13例23-B2型、15例23-B3型、10例23-C1型、7例23-C2型和10例23-C3型。随访1个月、2个月和12个月时，改良Mayo腕关节评分平均分别为38.11（标准差10.1；范围24-75，95%可信区间34.7-41.4）、67.22（标准差9.6，范围50-90，95%可信区间64-70.4）、90.54（标准差6.3，范围75-100，95%可信区间88.4-92.6）。不同随访期的平均评分之间存在统计学显著差异（p = 0.001）。我们注意到1例患者在手术干预后5个月出现远端螺钉固定无菌性松动。
PEEK增强碳纤维复合透射线钢板是治疗成人复杂桡骨远端骨折的一种有用装置。它具有独特的生物力学性能，有助于手术干预期间更轻松地进行解剖复位。
