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掌侧锁定板(VLP)治疗桡骨远端骨折的并发症和二次手术发生率。

Incidence of complications and secondary procedure following distal radius fractures treated by volar locking plate (VLP).

机构信息

Department of Foot and Ankle Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.

Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

J Orthop Surg Res. 2019 Sep 4;14(1):295. doi: 10.1186/s13018-019-1344-1.

DOI:10.1186/s13018-019-1344-1
PMID:31484547
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6727499/
Abstract

OBJECTIVE

To investigate the incidence of postoperative overall complications or secondary procedures following distal radius fractures treated by volar locking plate (VLP) METHODS: Electronic medical records (EMR) of 1152 patients with 1175 distal radius fractures treated by volar locking plate between January 2013 and September 2018 were retrospectively reviewed and the data were extracted. The picture archiving and communication system (PACS) was inquired to assess the fracture severity and to determine the fracture type. Univariate and multivariate logistic regression analyses were used to identify the associated risk factors.

RESULTS

During the median follow-up period of 6 months, a total of 138 complications in 131 patients were determined, indicating the accumulated rate of 11.7%; there were 68 cases of secondary procedures, with the rate of 5.8%. The independent associated factors for postoperative overall complications were AO type C fracture (OR, 2.6; 95%CI, 1.2 to 4.0), open fracture (OR, 4.2; 95%CI, 1.9 to 6.5), and significant collapse of the lunate fossa (OR, 2.9; 95%CI, 13 to 4.3), and for secondary procedures were significant collapse of the lunate fossa (OR, 3.7; 95%CI, 1.7 to 6.4) and the low-volume of surgeons (OR, 95%CI, 1.2 to 3.6) CONCLUSIONS: Identification of these factors is of importance for the risk assessment of postoperative complications and the additional need of surgery. For patients with the above factors, especially those with combined risk factors, optimized operation scheme and high-volume surgeon should be considered to prevent or reduce the complications.

摘要

目的

研究掌侧锁定板(VLP)治疗桡骨远端骨折术后总体并发症或二次手术的发生率。

方法

回顾性分析 2013 年 1 月至 2018 年 9 月期间采用掌侧锁定板治疗的 1152 例 1175 例桡骨远端骨折患者的电子病历(EMR)数据,并进行提取。通过图片存档与通信系统(PACS)评估骨折严重程度并确定骨折类型。采用单因素和多因素逻辑回归分析确定相关危险因素。

结果

在中位随访 6 个月期间,共确定 131 例患者的 138 例并发症,累积发生率为 11.7%;行二次手术 68 例,发生率为 5.8%。术后总体并发症的独立相关因素为:AO 分型 C 型骨折(OR,2.6;95%CI,1.2 至 4.0)、开放性骨折(OR,4.2;95%CI,1.9 至 6.5)和月骨窝明显塌陷(OR,2.9;95%CI,13 至 4.3),二次手术的独立相关因素为:月骨窝明显塌陷(OR,3.7;95%CI,1.7 至 6.4)和手术医生数量较少(OR,95%CI,1.2 至 3.6)。

结论

识别这些因素对于评估术后并发症风险和是否需要额外手术非常重要。对于存在上述因素的患者,尤其是存在合并危险因素的患者,应考虑优化手术方案和选择高手术量的医生,以预防或减少并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c0/6727499/14419166f8be/13018_2019_1344_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c0/6727499/f85ebee0ae70/13018_2019_1344_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c0/6727499/14419166f8be/13018_2019_1344_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c0/6727499/f85ebee0ae70/13018_2019_1344_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c0/6727499/14419166f8be/13018_2019_1344_Fig2_HTML.jpg

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