Quadlbauer S, Pezzei Ch, Jurkowitsch J, Rosenauer R, Kolmayr B, Keuchel T, Simon D, Beer T, Hausner T, Leixnering M
AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria.
Ludwig Boltzmann Institute for Experimental und Clinical Traumatology, AUVA Research Center, 1200, Vienna, Austria.
Arch Orthop Trauma Surg. 2020 May;140(5):651-663. doi: 10.1007/s00402-020-03367-w. Epub 2020 Mar 19.
Although the literature generally agrees that displaced distal radius fractures require surgery, no single consensus exists concerning the length of immobilization and type of post-operative physiotherapeutic rehabilitation program. Palmar locking plate fixation represents a very stable fixation of the distal radius, and was assessed biomechanically in various studies. Surprisingly, most authors report additional immobilization after plate fixation. One reason might be due to the pain caused during active wrist mobilization in the early post-operative stages or secondly to protect the osteosynthesis in the early healing stages preventing secondary loss of reduction. This article addresses the biomechanical principles, current available evidence for early mobilization/immobilization and impact of physiotherapy after operatively treated distal radius fractures.
尽管文献普遍认为桡骨远端移位骨折需要手术治疗，但对于固定时间的长短以及术后物理治疗康复方案的类型，目前尚未达成单一共识。掌侧锁定钢板固定是一种非常稳定的桡骨远端固定方式，已在多项研究中进行了生物力学评估。令人惊讶的是，大多数作者报告在钢板固定后仍需额外固定。一个原因可能是术后早期主动腕关节活动时引起的疼痛，其次是为了在愈合早期保护骨合成，防止复位丢失。本文探讨了手术治疗桡骨远端骨折后的生物力学原理、早期活动/固定的现有证据以及物理治疗的影响。
