Department of Orthopedics and Traumatology, Hitit University, Faculty of Medicine, Corum, Turkey.
Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey.
Med Sci Monit. 2018 Jan 19;24:377-386. doi: 10.12659/msm.907885.
BACKGROUND We aimed to evaluate the clinical and radiologic outcomes of using Sonoma WRx versus Micronail intramedullary nailing for the fixation of distal radius fractures. MATERIAL AND METHODS A total of 68 patients with primarily extra-articular and simple intra-articular fractures of the distal radius who underwent intramedullary distal radius fixation using Sonoma WRx (n=39) or Micronail (n=29) intramedullary nails were enrolled in the study. The clinical outcome measures included the range of motion (ROM), visual analog scale (VAS), functional outcomes (patient-reported Disabilities of the Arm, Shoulder and Hand [DASH] score and clinician-based Gartland-Werley score), radiographic scores (Stewart score), and parameters related to the quality of radiographic reduction and complications (radial inclination, volar tilt, radial height, and radio-ulnar variance). RESULTS Significantly higher DASH (15.0±3.3 vs. 8.3±1.5, p<0.001) and Gartland-Werley (4.9±5.4 vs. 2.9±4.2, p=0.029) scores, longer scopy time (21.0±3.9 min vs. 15.8±2.5 min, p<0.001), lower ROM for wrist extension (69.5±4.4° vs. 77.1±7.6°, p<0.001), higher ROM for wrist supination (81.9±5.1° vs. 78.7±3.1°, p<0.001), and higher complications rates (37.9% vs. 15.4%, p=0.034) were noted in the Micronail group compared to those in the Sonoma WRx group. CONCLUSIONS Our findings revealed that Sonoma WRx and Micronail implants were equally effective and useful minimally invasive options for treating distal radius fractures. Further, we consider Sonoma WRx superior in terms of shorter operative time, lower complication rates, and better functional outcome scores.
我们旨在评估 Sonoma WRx 与 Micronail 髓内钉治疗桡骨远端骨折的临床和影像学结果。
本研究共纳入 68 例主要为关节外和简单关节内桡骨远端骨折患者,分别采用 Sonoma WRx(n=39)或 Micronail(n=29)髓内钉进行髓内远端桡骨固定。临床疗效评价指标包括活动范围(ROM)、视觉模拟评分(VAS)、功能结果(患者报告的上肢功能障碍、肩部和手[DASH]评分和基于临床医生的 Gartland-Werley 评分)、影像学评分(Stewart 评分)以及与影像学复位质量和并发症相关的参数(桡骨倾斜度、掌倾角、桡骨高度和桡尺骨间距)。
与 Micronail 组相比,Sonoma WRx 组患者的 DASH(15.0±3.3 比 8.3±1.5,p<0.001)和 Gartland-Werley(4.9±5.4 比 2.9±4.2,p=0.029)评分更高,透视时间更长(21.0±3.9 min 比 15.8±2.5 min,p<0.001),腕关节伸展活动范围更小(69.5±4.4°比 77.1±7.6°,p<0.001),腕关节旋前活动范围更大(81.9±5.1°比 78.7±3.1°,p<0.001),并发症发生率更高(37.9%比 15.4%,p=0.034)。
我们的研究结果表明,Sonoma WRx 和 Micronail 植入物是治疗桡骨远端骨折的微创有效选择,具有相同的效果。此外,我们认为 Sonoma WRx 在手术时间更短、并发症发生率更低和功能结果评分更好方面更具优势。