Sugiyama Yoichi, Naito Kiyohito, Obata Hiroyuki, Kinoshita Mayuko, Goto Kenji, Nagura Nana, Iwase Yoshiyuki, Kaneko Kazuo
Department of Orthopaedics, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo, 136-0075, Japan.
Ann Med Surg (Lond). 2018 Sep 25;35:73-75. doi: 10.1016/j.amsu.2018.09.028. eCollection 2018 Nov.
In this study, we retrospectively surveyed the presence or absence of pisiform subluxation in surgically treated distal radius fractures (DRF) cases. In addition, we investigated whether or not the postoperative short-term treatment outcome differs due to the presence of pisiform subluxation.
The subjects were 134 DRF patients treated with volar locking plate fixation (53 males and 81 females, mean age: 64 years old). The pisotriquetral joint was observed on a preoperative CT to investigate the presence or absence of pisiform subluxation according to the criteria reported by Vasilas. 134 patients divided into subluxation group and non-subluxation group, and the clinical outcomes were compared between these groups.
Pisiform subluxation was noted in 23.1% (31 patients, 15 males and 16 females, mean age 61 years). No significant difference was noted in patient background in both groups. The postoperative pronation angle in the non-subluxation group was significantly greater than that in the subluxation group, but there was no significant difference in any other parameter (the range of motion of the wrist, grip strengths, VAS, Q-DASH scores, and Mayo score) between these 2 groups. However it concomitantly occurred in 23.1% of DRF cases in our series, there was no significant difference in the postoperative treatment outcome between these 2 groups.
Therapeutic intervention of pisiform subluxation is unnecessary during treatment of DRF, since pisiform subluxation does not affect the postoperative clinical outcomes of distal radius fractures.
在本研究中,我们回顾性调查了手术治疗的桡骨远端骨折(DRF)病例中豌豆骨半脱位的情况。此外,我们还研究了豌豆骨半脱位的存在是否会导致术后短期治疗结果有所不同。
研究对象为134例接受掌侧锁定钢板固定治疗的DRF患者(53例男性,81例女性,平均年龄:64岁)。术前通过CT观察豌豆三角关节,根据Vasilas报告的标准调查豌豆骨半脱位的情况。将134例患者分为半脱位组和非半脱位组,并比较两组的临床结果。
发现23.1%(31例患者,15例男性,16例女性,平均年龄61岁)存在豌豆骨半脱位。两组患者的背景无显著差异。非半脱位组术后旋前角度显著大于半脱位组,但两组在任何其他参数(腕关节活动范围、握力、视觉模拟评分、QuickDASH评分和梅奥评分)上均无显著差异。然而,在我们的系列研究中,豌豆骨半脱位在23.1%的DRF病例中同时出现,两组术后治疗结果并无显著差异。
在DRF治疗期间无需对豌豆骨半脱位进行治疗干预,因为豌豆骨半脱位不会影响桡骨远端骨折的术后临床结果。