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比较外固定架与掌侧锁定钢板治疗桡骨远端关节内骨折的前瞻性随机研究:哪种方法更好?

Prospective Randomized Study Comparing the External Fixator and Volar Locking Plate in Intraarticular Distal Radius Fractures: Which Is Better?

作者信息

Sharma Aryan, Pathak Subodh, Sandhu Harinder, Bagtharia Priyank, Kumar Naveen, Bajwa Rajdeep S, Pruthi Vineet, Chawla Jasneet S

机构信息

Orthopedics, Maharishi Markandeshwar Institute of Medical Sciences and Research. Maharishi Markandeshwar (deemed to be University), Ambala, IND.

出版信息

Cureus. 2020 Feb 2;12(2):e6849. doi: 10.7759/cureus.6849.

Abstract

Introduction Various treatment options for patients with an intraarticular distal radius fracture are available, but in cases of comminuted fractures, these narrow down to either a volar locking plate, an external fixator, or a combination of these two. We conducted this prospective study to compare the external fixation and internal fixation of intraarticular fractures of the distal radius in terms of clinical/functional outcome and complications and with the available literature. Material and method This prospective randomized study consisted of a total number of 30 patients with intraarticular fractures of the distal end of the radius divided randomly into two groups (A and B), treated by external fixation (Group A) and volar plating (Group B), in a tertiary care institute during the study period. Result The most patients were males >50 years of age, with injury to the right dominant hand most commonly caused by a fall on an outstretched hand. As per the modified Green & O'Brien scoring system, the volar plating group showed the final result as excellent in two (13.33%), good in seven (46.6%), fair in four (26.6%), and poor in two (13.3%) whereas an excellent outcome was seen in one (6.66%), good and fair in five patients each (33.3%), and poor in four (26.66%) patients at the six months follow-up. Conclusion Overall, both fixation techniques seem to apply sufficient stabilization to restore function and retain anatomy; however, volar locking plates have certain advantages over external fixator in the early postop period in terms of earlier recovery and mobilization.

摘要

引言 对于桡骨远端关节内骨折患者有多种治疗选择,但对于粉碎性骨折,这些选择可归结为掌侧锁定钢板、外固定器或两者结合。我们进行这项前瞻性研究,以比较桡骨远端关节内骨折的外固定和内固定在临床/功能结果及并发症方面的情况,并与现有文献进行对比。

材料与方法 这项前瞻性随机研究共纳入30例桡骨远端关节内骨折患者,在研究期间于一家三级医疗机构随机分为两组(A组和B组),分别采用外固定(A组)和掌侧钢板固定(B组)进行治疗。

结果 大多数患者为50岁以上男性,最常见的致伤原因是伸腕位跌倒致右侧优势手受伤。根据改良的Green & O'Brien评分系统,掌侧钢板固定组最终结果为优2例(13.33%)、良7例(46.6%)、可4例(26.6%)、差2例(13.3%);而在6个月随访时,外固定组优1例(6.66%)、良和可各5例(33.3%)、差4例(26.66%)。

结论 总体而言,两种固定技术似乎都能提供足够的稳定性以恢复功能并保持解剖结构;然而,在术后早期,掌侧锁定钢板在恢复和活动方面比外固定器具有一定优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27a4/7053667/3738197fb7eb/cureus-0012-00000006849-i01.jpg

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