Tareen Jarid, Kaufman Adam M, Pensy Raymond A, O'Toole Robert V, Eglseder W Andrew
Orthopedics. 2019 Jul 1;42(4):219-225. doi: 10.3928/01477447-20190625-05.
The authors aimed to characterize surgical and functional outcomes of open fractures of the distal radius in patients younger than 65 years. At their level I trauma center, the authors conducted a retrospective review of 92 patients (age range, 16-64 years) who had 94 open fractures of the distal radius (average follow-up, 30 months; range, 3-95 months). Sixty-four fractures received definitive treatment at the time of initial débridement; 30 received definitive fixation and soft tissue coverage after staged débridement. Primary surgical outcome was development of deep surgical site infection requiring repeat surgical débridement; secondary surgical outcome was surgical complications requiring reoperation. Functional outcome was assessed by wrist range of motion. Overall infection rate was 15% (14 of 94 fractures). Seven (11%) of 64 fractures in the immediate definitive fixation group developed infection compared with 7 (23%) of 30 fractures in the staged treatment group (P=.13). Twenty-one (33%) of 64 fractures in the immediate definitive fixation group required reoperation compared with 15 (50%) of 30 in the staged treatment group (P=.11). Deep surgical site infections and surgical complications associated with open fractures of the distal radius are driven by soft tissue injury. [Orthopedics. 2019; 42(4):219-225.].
作者旨在描述65岁以下桡骨远端开放性骨折患者的手术及功能预后情况。在其I级创伤中心，作者对92例（年龄范围16 - 64岁）桡骨远端开放性骨折患者进行了回顾性研究（共94处骨折；平均随访30个月，范围3 - 95个月）。64处骨折在初次清创时即接受了确定性治疗；30处骨折在分期清创后接受了确定性固定及软组织覆盖。主要手术预后是发生深部手术部位感染需要再次手术清创；次要手术预后是需要再次手术的手术并发症。通过腕关节活动范围评估功能预后。总体感染率为15%（94处骨折中有14处）。一期确定性固定组64处骨折中有7处（11%）发生感染，而分期治疗组30处骨折中有7处（23%）发生感染（P = 0.13）。一期确定性固定组64处骨折中有21处（33%）需要再次手术，而分期治疗组30处骨折中有15处（50%）需要再次手术（P = 0.11）。桡骨远端开放性骨折相关的深部手术部位感染及手术并发症是由软组织损伤所致。[《骨科学》。2019年；42(4):219 - 225。]
