Department of Trauma and Hand Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
Trauma Unit, Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
J Hand Surg Eur Vol. 2020 May;45(4):327-332. doi: 10.1177/1753193419866128. Epub 2019 Nov 5.
The aim of this study was to determine the difference in functional outcomes after open reduction and internal fixation (ORIF) with and without arthroscopic debridement in adults with displaced intra-articular distal radius fractures. In this multicentre trial, 50 patients were randomized between ORIF with or without arthroscopic debridement. The primary outcome measure was the Patient-Rated Wrist Evaluation (PRWE) score. Secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, pain scores, range of wrist motion, grip strength, and complications. Median PRWE was worse for the intervention group at 3 months and was equal for both groups at 12 months. The secondary outcome measures did not show consistent patterns of differences at different time-points of follow-up. We conclude that patients treated with additional arthroscopy to remove intra-articular hematoma and debris did not have better outcomes than those treated with ORIF alone. We therefore do not recommend arthroscopy for removal of hematoma and debris when surgically fixing distal radius fractures. I.
本研究旨在确定成人移位关节内桡骨远端骨折切开复位内固定（ORIF）联合与不联合关节镜清理术在功能结果方面的差异。在这项多中心试验中，50 例患者被随机分为 ORIF 联合或不联合关节镜清理术组。主要结局测量指标为患者腕关节评分（PRWE）。次要结局测量指标包括上肢功能障碍问卷（DASH）、疼痛评分、腕关节活动范围、握力和并发症。干预组在 3 个月时的 PRWE 中位数更差，而两组在 12 个月时的结果相等。次要结局测量指标在不同随访时间点没有一致的差异模式。我们的结论是，与单独接受 ORIF 治疗的患者相比，接受关节镜清除术以去除关节内血肿和碎片的患者没有更好的结果。因此，当手术固定桡骨远端骨折时，我们不建议使用关节镜清除血肿和碎片。
