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乔希外固定系统在移位性关节内桡骨远端骨折中的应用长期研究

A Long-Term Study of Application of Joshi's External Stabilizing System in Displaced Intra-articular Distal End Radius Fractures.

作者信息

Shukla Rajeev, Champawat Vishal Singh, Jain Ravi Kant

机构信息

Department of Orthopedics, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.

出版信息

J Wrist Surg. 2019 Feb;8(1):49-54. doi: 10.1055/s-0038-1668560. Epub 2018 Aug 19.

Abstract

Fractures of the distal end radius are a common upper extremity fracture. Intra-articular distal end radius fractures are recognized as very complex injuries with a variable prognosis. The aim of the study was to assess the long-term functional outcome of patients treated with Joshi's external stabilizing system (JESS) for displaced intra-articular distal end radius fractures.  A total of 170 patients with intra-articular distal end radius fracture were treated with JESS from 2014 to 2017. The patients were followed up at 2, 6 weeks, 6 months, 1, and 2 years (final) after the surgery. The assessment of pain, range of motion, grip strength, and satisfaction were assessed at 6 months, 1, and 2 years (final) follow-up and scored according to modified Mayo wrist scoring system.  The good and/or excellent results were found in 82.2% of cases. We observed that patients with age less than 50 years had greater prognosis as compared with patients with more than 50 years of age. Final outcome was also found better in males as compared with females at 6 months, 1, and 2 years postoperatively.  JESS is an effective treatment technique for intra-articular distal end radius fractures in our community. On long-term follow-up of the patients treated with JESS for intra-articular distal end radius fractures, the functional and radiological outcomes were good with low complication rate.

摘要

桡骨远端骨折是一种常见的上肢骨折。桡骨远端关节内骨折被认为是非常复杂的损伤,预后不一。本研究的目的是评估采用乔希外固定系统(JESS)治疗移位型桡骨远端关节内骨折患者的长期功能结局。

2014年至2017年,共有170例桡骨远端关节内骨折患者接受了JESS治疗。术后在2周、6周、6个月、1年和2年(最终随访)对患者进行随访。在6个月、1年和2年(最终随访)时评估疼痛、活动范围、握力和满意度,并根据改良的梅奥腕关节评分系统进行评分。

82.2%的病例结果为良好和/或优秀。我们观察到,年龄小于50岁的患者比年龄大于50岁的患者预后更好。在术后6个月、1年和2年时,男性的最终结局也比女性更好。

JESS是我们社区治疗桡骨远端关节内骨折的一种有效治疗技术。对采用JESS治疗桡骨远端关节内骨折的患者进行长期随访,其功能和影像学结局良好,并发症发生率低。

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本文引用的文献

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Treatment of distal radius fractures.桡骨远端骨折的治疗。
J Am Acad Orthop Surg. 2010 Mar;18(3):180-9. doi: 10.5435/00124635-201003000-00007.
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Surgical Correction of Malunited Fractures of the Distal Radius.桡骨远端骨折畸形愈合的手术矫正
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