Duprat André, Diaz Juan José Hidalgo, Vernet Paul, Gouzou Stéphanie, Facca Sybille, Igeta Yuka, Liverneaux Philippe
Department of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, Translational Medicine Federation Strasbourg, University of Strasbourg, Illkirch, France.
Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.
J Wrist Surg. 2018 Jul;7(3):237-242. doi: 10.1055/s-0037-1620271. Epub 2018 Jan 16.
The goal of this study was to demonstrate that the use of a splint after performing an osteosynthesis of the distal radius with a volar locking plate is unnecessary. The main hypothesis was that postoperative flexion of the wrist was greater without a splint. Secondary hypothesis was that patients who were allowed immediate mobilization got better results in terms of pain, Quick Disabilities of the Arm, Shoulder and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), strength, extension, pronation, and supination. Our series included 72 patients, aged 59 years in average of which 59 were female patients. All patients had been operated for a volar locking plate fixation of a distal radius fracture. The first 36 patients (group I) were immobilized by a splint at 30° of extension of the wrist for 2 weeks. The following 36 patients (group II) were not immobilized. At 3 months, all the average variables were better in the group without splint (group I: flexion 74.83%, extension 83.13%, pronation 92.07%, supination 88.11%, pain 1.72/10, Quick DASH 21.78/100, PRWE 22.97/100, strength 62.96%; group II: flexion 85.50%, extension 83.4%, pronation 92.96%, supination 92.96%, pain 1.28/10, Quick DASH 19.57/100, PRWE 20.56/100, strength 66.34%). No complication was reported. Overall, our results demonstrate that wearing a splint after volar locking plate fixation of a distal radius fracture is unnecessary.
本研究的目的是证明在使用掌侧锁定钢板对桡骨远端进行接骨术后使用夹板是不必要的。主要假设是不使用夹板时腕关节术后的屈曲角度更大。次要假设是允许立即活动的患者在疼痛、手臂、肩部和手部快速残疾评定量表（DASH）、患者自评腕关节评估量表（PRWE）、力量、伸展、旋前和旋后方面取得更好的结果。我们的研究系列包括72例患者，平均年龄59岁，其中59例为女性患者。所有患者均接受了掌侧锁定钢板固定桡骨远端骨折的手术。前36例患者（第一组）用夹板将腕关节固定在伸展30°位2周。接下来的36例患者（第二组）未进行固定。在3个月时，未使用夹板的组（第一组：屈曲74.83%，伸展83.13%，旋前92.07%，旋后88.11%，疼痛1.72/10，快速DASH 21.78/100，PRWE 22.97/100，力量62.96%；第二组：屈曲85.50%，伸展83.4%，旋前92.96%，旋后92.96%，疼痛1.28/10，快速DASH 19.57/100，PRWE 20.56/100，力量66.34%）所有平均变量均更好。未报告并发症。总体而言，我们的结果表明，桡骨远端骨折掌侧锁定钢板固定术后佩戴夹板是不必要的。
