University of Cincinnati, OH, USA.
Hand (N Y). 2022 May;17(3):512-518. doi: 10.1177/1558944720922923. Epub 2020 Jun 29.
This study compares the functional outcomes and complications between operatively and nonoperatively treated distal ulnar head and neck fractures associated with internal fixation of concomitant distal radius fractures. A 7-year retrospective chart review was performed to identify patients with operatively treated distal radius fractures associated with distal ulnar head and neck fractures. Ulnar styloid fractures were excluded. Fifty-eight patients who had a minimum of 6 months of follow-up were identified. Patients were divided into 3 treatment groups: nonoperative, open reduction internal fixation (ORIF), and distal ulna resection. Reviewed data included demographics, injury and treatment details, complications, and patient-reported outcome measures. Outcomes measures included Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity and Patient-Rated Wrist Evaluation (PRWE) surveys. Due to inadequate power, 5 patients treated with distal ulna resection were excluded from statistical analysis. The average patient age was 56 years, with an average follow-up of 27 months. All patients underwent ORIF of the distal radius fracture. Distal ulna fractures were treated nonoperatively in 25 patients, with ORIF in 28 patients, and with distal ulna resection in 5 patients. There were no statistically significant differences in wrist or forearm range of motion, complication rates, secondary procedure rates, PRWE scores, or PROMIS scores between ORIF and nonoperative treatment. No differences in wrist or forearm range of motion, complication rates, secondary procedure rates, PRWE scores, or PROMIS scores were observed between ORIF and nonoperative treatment of distal ulnar head and neck fractures associated with operatively treated distal radius fractures.
本研究比较了手术和非手术治疗伴内固定的桡骨远端骨折的尺骨远端头颈部骨折的功能结果和并发症。对 7 年的回顾性图表进行了回顾,以确定手术治疗的桡骨远端骨折伴尺骨远端头颈部骨折的患者。排除了尺骨茎突骨折。确定了 58 名至少有 6 个月随访的患者。患者分为 3 个治疗组:非手术、切开复位内固定(ORIF)和尺骨切除。回顾的数据包括人口统计学、损伤和治疗细节、并发症以及患者报告的结果测量。结果测量包括患者报告的结果测量信息系统(PROMIS)上肢和患者评定腕部评估(PRWE)调查。由于有效力量不足,5 名接受尺骨切除术治疗的患者被排除在统计分析之外。平均患者年龄为 56 岁,平均随访时间为 27 个月。所有患者均接受了桡骨远端骨折的 ORIF。25 例尺骨远端骨折采用非手术治疗,28 例采用 ORIF 治疗,5 例采用尺骨切除术治疗。ORIF 与非手术治疗在腕关节或前臂活动范围、并发症发生率、二次手术率、PRWE 评分或 PROMIS 评分方面无统计学差异。在与手术治疗的桡骨远端骨折相关的尺骨远端头颈部骨折的 ORIF 和非手术治疗中,未观察到腕关节或前臂活动范围、并发症发生率、二次手术率、PRWE 评分或 PROMIS 评分的差异。