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≥50岁患者不稳定型桡骨远端骨折的早期混合非桥接外固定

Early hybrid nonbridging external fixation of unstable distal radius fractures in patients aged ≥50 years.

作者信息

Cheng Pengfei, Wu Fan, Chen Hua, Jiang Chaoyin, Wang Ting, Han Pei, Chai Yimin

机构信息

Orthopaedic Department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

J Int Med Res. 2020 Apr;48(4):300060519879562. doi: 10.1177/0300060519879562. Epub 2019 Dec 23.

Abstract

OBJECTIVE

We evaluated hybrid nonbridging external fixation (NBEF) supplemented by K-wires as an effective and safe treatment option for osteoporotic distal radius fractures (DRFs) in a retrospective case series.

METHODS

Sixteen extra-articular and one intra-articular DRF were treated by NBEF from 2016 to 2018 (mean patient age, 61.8 years; 15 women, 1 man). Radiographic parameters (volar tilt, radial inclination, and ulnar variance), range of motion, grip power, the visual analog scale score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed at 4 weeks, 6 weeks, 6 months, and 12 months postoperatively.

RESULTS

The volar tilt and radial inclination were restored after surgery and maintained well. The mean visual analog scale score was 4 ± 1 at 4 weeks. Range of motion was restored to 79% to 91% at 6 weeks. The DASH score was good before NBEF device removal. Two superficial pin-tract infections were easily treated with antibiotics.

CONCLUSIONS

Hybrid NBEF transfixes DRFs in a multiplanar fashion, and augmentation with percutaneous K-wires provides direct fixation in radial shift and withstands axial loads in fracture fragments. It allows early mobilization with rigid fixation. Hybrid NBEF is reliable for unstable extra-articular and simple intra-articular DRFs in older patients.

CLINICAL STUDY REGISTRATION NUMBER

ChiCTR1900021712.

摘要

目的

在一项回顾性病例系列研究中,我们评估了辅以克氏针的混合式非桥接外固定(NBEF)作为骨质疏松性桡骨远端骨折(DRF)的一种有效且安全的治疗选择。

方法

2016年至2018年期间,16例关节外和1例关节内DRF采用NBEF治疗(患者平均年龄61.8岁;15名女性,1名男性)。在术后4周、6周、6个月和12个月时评估影像学参数(掌倾角、桡偏角和尺骨变异)、活动范围、握力、视觉模拟评分以及手臂、肩部和手部功能障碍(DASH)评分。

结果

术后掌倾角和桡偏角得以恢复并维持良好。4周时平均视觉模拟评分为4±1。6周时活动范围恢复至79%至91%。在拆除NBEF装置前DASH评分良好。两例浅表针道感染经抗生素治疗后容易治愈。

结论

混合式NBEF以多平面方式固定DRF,经皮克氏针增强固定可直接纠正桡骨移位并承受骨折碎片的轴向负荷。它允许在坚强固定的情况下早期活动。混合式NBEF对于老年患者不稳定的关节外和简单关节内DRF是可靠的。

临床研究注册号

ChiCTR1900021712。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1740/7783266/8cebda863e0c/10.1177_0300060519879562-fig1.jpg

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