Dwyer C Liam, Crosby Nicholas E, Cooney Timothy, Seeds William, Lubahn John D
Orthopaedic Surgical Residency, UPMC Hamot, Erie, PA.
Am J Orthop (Belle Mead NJ). 2017 Sep/Oct;46(5):E344-E352.
We conducted a study to compare functional and radiographic outcomes of unstable comminuted intra-articular distal radius fractures (DRFs) treated with a nonspanning external fixation device and outcomes achieved with volar locking plates in a historical control group. Clinical and radiographic data from 25 patients with these fractures, treated with the external fixation device, were compared with outcomes data from historical control matched patients with fracture patterns treated with volar locking plates. There was no statistically significant difference in the measured outcomes for wrist flexion and extension, radial deviation, pronation and supination, volar tilt, radial height, radial inclination, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores between the 2 groups. The external fixator group had significantly more postoperative ulnar deviation than the historical control group. Complications included pin-tract infection and fracture in 1 patient who fell 2 weeks after fixator removal. Nonspanning external fixation is an alternative treatment option for unstable comminuted DRFs. It is minimally invasive and has functional and radiographic results similar to those achieved with volar locking plates in matched patients in historical control studies.
我们开展了一项研究,比较使用非跨关节外固定装置治疗的不稳定粉碎性桡骨远端关节内骨折(DRF)的功能和影像学结果,以及在一个历史对照组中使用掌侧锁定钢板所取得的结果。将25例接受外固定装置治疗的此类骨折患者的临床和影像学数据,与历史对照中采用掌侧锁定钢板治疗的具有相同骨折类型的匹配患者的结果数据进行比较。两组之间在腕关节屈伸、桡偏、旋前和旋后、掌倾角、桡骨高度、桡骨倾斜度以及上肢、肩部和手部功能障碍(DASH)评分的测量结果上,均无统计学显著差异。外固定器组术后尺偏明显多于历史对照组。并发症包括1例患者在固定器拆除2周后跌倒出现的针道感染和骨折。非跨关节外固定是不稳定粉碎性DRF的一种替代治疗选择。它微创,在历史对照研究中,与匹配患者使用掌侧锁定钢板所取得的功能和影像学结果相似。