Boretto Jorge G, Zaidenberg Ezequiel E, Gallucci Gerardo L, Sarme Alejandro, De Carli Pablo
1 Hospital Italiano de Buenos Aires, Argentina.
Hand (N Y). 2019 Jul;14(4):540-546. doi: 10.1177/1558944718760000. Epub 2018 Feb 20.
Acute management of fractures of the distal ulna that are associated with fractures of the distal radius remains difficult, particularly in the elderly. In this study, we investigated whether internal fixation of the distal ulna is associated with a higher rate of complications than resection of the distal ulna in patients older than 70 years. Twenty-four consecutive patients were included in this study, 12 of whom had undergone open reduction and internal fixation (ORIF) of the distal ulna, and 12 who had undergone distal ulna resection. Patients were retrospectively assessed for range of motion, grip strength, pain, and radiographic appearance. The functional outcome was evaluated by the Mayo Wrist Score. Complications were classified according to the Classification of Surgical Complications. There were no differences in patient demographics between the 2 groups, except patient age. Clinical evaluation showed no difference at follow-up; however, there were significantly more complications associated with ORIF compared with resection. The results from our study show that women older than 70 years with fracture of the distal radius and distal ulna have a higher rate of complications if ORIF of the distal ulna is performed. Patients should be warned, by surgeons, of this in cases where ORIF of the distal ulna is suggested.
与桡骨远端骨折相关的尺骨远端骨折的急性处理仍然很困难,尤其是在老年人中。在本研究中,我们调查了70岁以上患者中,尺骨远端内固定术与尺骨远端切除术相比,并发症发生率是否更高。本研究纳入了24例连续病例,其中12例行尺骨远端切开复位内固定术(ORIF),12例行尺骨远端切除术。对患者的活动范围、握力、疼痛和影像学表现进行回顾性评估。功能结局通过梅奥腕关节评分进行评估。并发症根据手术并发症分类进行分类。除患者年龄外,两组患者的人口统计学特征无差异。临床评估显示随访时无差异;然而,与切除术相比,ORIF相关的并发症明显更多。我们的研究结果表明,70岁以上桡骨远端和尺骨远端骨折的女性患者,如果进行尺骨远端ORIF,并发症发生率更高。外科医生在建议进行尺骨远端ORIF的情况下,应向患者警告这一点。