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如果采用关节镜辅助治疗,伴有其他损伤的桡骨远端骨折的治疗结果与单纯桡骨远端骨折相似。

The Outcome of Distal Radius Fractures with Concomitant Injuries Is Similar to those of Isolated Distal Radius Fractures Provided that an Arthroscopically Supported Treatment Is Performed.

作者信息

von Matthey Francesca, Schmid Karola, Zyskowski Michael, Deiler Stephan, Biberthaler Peter, Vester Helen

机构信息

Clinic for Traumatology, Klinikum rechts der Isar, Technical University of Munich, 81667 Munich, Germany.

Clinic for Traumatology, Department for Handsurgery, Klinikum rechts der Isar, Technical University of Munich, 81667 Munich, Germany.

出版信息

J Clin Med. 2020 Apr 1;9(4):974. doi: 10.3390/jcm9040974.

Abstract

BACKGROUND

Concomitant injuries of distal radius fractures (DRF) can have a fatal impact on the patients' outcome. However, wrist arthroscopy is a costly and complex procedure. It remains elusive whether patients benefit from an additional arthroscopy.

METHODS

Patients with a DRF who were treated arthroscopically were enrolled. Fifty-six wrists were evaluated regarding their function by self-assessment with the Munich Wrist Questionnaire (MWQ). Thirty-nine patients were examined for postoperative strength and motion. Concomitant injuries were detected.

RESULTS

A total of 75% of the DRF were type C injuries (AO classification). Twenty-four cases (43%) were triangular fibrocartilaginous complex (TFCC) lesion, eight cases (14%) of scapholunate ligament (SL) injuries and seven cases (12%) were a combination of TFCC and SL ligament lesion. No difference in function could be detected between DRF with surgically addressed concomitant lesions and isolated DRF. Dorsalextension, palmarflexion and grip strength were significantly reduced in patients with DRF and concomitant injuries compared to the healthy wrist. However, patients with DRF and arthroscopically treated concomitant injuries had similar results to those suffering only from an isolated DRF.

CONCLUSION

The increased occurrence of concomitant injuries is to be expected in intraarticular DRF. Patients with concomitant injuries benefit from an arthroscopically assisted fracture treatment and show similar results compared to isolated DRF.

摘要

背景

桡骨远端骨折(DRF)合并损伤会对患者的预后产生致命影响。然而,腕关节镜检查是一种成本高昂且复杂的手术。患者是否能从额外的关节镜检查中获益仍不明确。

方法

纳入接受关节镜治疗的DRF患者。通过慕尼黑腕关节问卷(MWQ)进行自我评估,对56个腕关节的功能进行评估。对39例患者进行术后力量和活动度检查,检测合并损伤情况。

结果

总共75%的DRF为C型损伤(AO分类)。24例(43%)为三角纤维软骨复合体(TFCC)损伤,8例(14%)为舟月韧带(SL)损伤,7例(12%)为TFCC和SL韧带联合损伤。手术处理合并损伤的DRF与单纯DRF在功能上未发现差异。与健康腕关节相比,DRF合并损伤患者的背伸、掌屈和握力明显降低。然而,接受关节镜治疗合并损伤的DRF患者与仅患有单纯DRF的患者结果相似。

结论

关节内DRF合并损伤的发生率增加是可以预期的。合并损伤的患者从关节镜辅助骨折治疗中获益,与单纯DRF患者相比结果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a526/7230906/5f46e2f581f8/jcm-09-00974-g001.jpg

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