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双侧桡骨远端骨折切开复位内固定术的疗效

Outcomes of Open Reduction and Internal Fixation of Bilateral Fractures of the Distal Radius.

作者信息

Graham Jack G, Penna Sreeram, Fletcher Daniel, Kwok Moody, Aita Daren J, Takei T Robert, Beredjiklian Pedro K

机构信息

Department of Orthopedic Surgery, The Rothman Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.

出版信息

J Hand Microsurg. 2019 Aug;11(2):117-120. doi: 10.1055/s-0039-1688512. Epub 2019 May 26.

Abstract

Bilateral distal radius fracture (DRF) is an uncommon injury. We described the outcomes of 10 consecutive cases of bilateral DRF treated with open reduction and internal fixation (ORIF) at our institution. We retrospectively searched our electronic medical records data for all patients 18 years of age or older treated surgically for bilateral DRF over a 6-year period (2011-2016). Patient demographics, fracture classification, fixation method, postoperative complications, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) questionnaire scores, wrist range of motion (ROM), and radiographic measurements of X-rays at final follow-up were collected and analyzed. Ten patients (8 women; 2 men; mean age: 63 years) with 20 fractures were assessed. A volar approach for ORIF was used in 90% of cases. Six of 20 (30%) wrists experienced postoperative complications and required hardware removal. Mean QuickDASH score was 24.8 at final follow-up. On average, ROM reached 58-degree extension, 52-degree flexion, 75-degree pronation, and 75-degree supination. Mean measurements of radial shortening, radial inclination, and volar tilt taken from final postoperative radiographs were 1.3 mm, 21.2 degrees, and 7.8 degrees, respectively. In bilateral DRF treated with concomitant ORIF, functional outcomes, recovery of wrist ROM, and restoration of radiographic parameters are comparable to those seen in patients with ipsilateral DRF.

摘要

双侧桡骨远端骨折(DRF)是一种罕见的损伤。我们描述了在我们机构连续10例接受切开复位内固定术(ORIF)治疗的双侧DRF患者的治疗结果。我们回顾性检索了我们电子病历数据中在6年期间(2011 - 2016年)接受手术治疗双侧DRF的所有18岁及以上患者。收集并分析了患者人口统计学资料、骨折分类、固定方法、术后并发症、QuickDASH(上肢、肩部和手部快速残疾)问卷评分、腕关节活动范围(ROM)以及末次随访时X线片的影像学测量结果。对10例患者(8名女性;2名男性;平均年龄:63岁)共20处骨折进行了评估。90%的病例采用掌侧入路进行切开复位内固定术。20例手腕中有6例(30%)出现术后并发症并需要取出内固定物。末次随访时QuickDASH平均评分为24.8。平均而言,活动范围达到伸展58度、屈曲52度、旋前75度和旋后75度。术后末次X线片测得的桡骨短缩、桡骨倾斜和掌倾角的平均测量值分别为1.3毫米、21.2度和7.8度。在接受同期切开复位内固定术治疗的双侧DRF中,功能结果、腕关节活动范围的恢复以及影像学参数的恢复与同侧DRF患者相当。

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