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Volar Locking Plates Versus Augmented External Fixation of Intra-Articular Distal Radial Fractures: Functional Results from a Randomized Controlled Trial.掌侧锁定钢板与关节外增强固定治疗关节内桡骨远端骨折:一项随机对照试验的功能结果。
J Bone Joint Surg Am. 2019 Feb 20;101(4):311-321. doi: 10.2106/JBJS.18.00014.
2
Considerations in the Treatment of Osteoporotic Distal Radius Fractures in Elderly Patients.老年患者骨质疏松性桡骨远端骨折的治疗考量
Curr Rev Musculoskelet Med. 2019 Mar;12(1):50-56. doi: 10.1007/s12178-019-09531-z.
3
The Effect of Osteoporosis on the Outcomes After Volar Locking Plate Fixation in Female Patients Older than 50 Years With Unstable Distal Radius Fractures.骨质疏松对50岁以上女性不稳定桡骨远端骨折患者掌侧锁定钢板固定术后疗效的影响
J Hand Surg Am. 2018 Aug;43(8):731-737. doi: 10.1016/j.jhsa.2018.05.028. Epub 2018 Jul 2.
4
Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement.骨质疏松症筛查以预防骨折:美国预防服务工作组推荐声明。
JAMA. 2018 Jun 26;319(24):2521-2531. doi: 10.1001/jama.2018.7498.
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Correlation Between Radiological Parameters and Functional Outcomes in Patients Older Than 60 Years of Age With Distal Radius Fracture.60岁以上桡骨远端骨折患者影像学参数与功能预后的相关性
Hand (N Y). 2019 Nov;14(6):770-775. doi: 10.1177/1558944718770203. Epub 2018 Apr 17.
6
Pharmacological Therapy of Osteoporosis: A Systematic Current Review of Literature.骨质疏松症的药物治疗:文献的系统当前综述
Front Pharmacol. 2017 Nov 7;8:803. doi: 10.3389/fphar.2017.00803. eCollection 2017.
7
A systematic review of volar locking plate removal after distal radius fracture.桡骨远端骨折后掌侧锁定钢板取出的系统评价
Injury. 2017 Dec;48(12):2650-2656. doi: 10.1016/j.injury.2017.10.010. Epub 2017 Oct 9.
8
Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating.老年患者桡骨远端关节内骨折:石膏固定与掌侧钢板固定的随机前瞻性研究
J Hand Surg Eur Vol. 2018 Feb;43(2):142-147. doi: 10.1177/1753193417727139. Epub 2017 Sep 4.
9
Epidemiology and time trends of distal forearm fractures in adults - a study of 11.2 million person-years in Sweden.成人前臂远端骨折的流行病学及时间趋势——一项基于瑞典1120万人年的研究
BMC Musculoskelet Disord. 2017 Jun 2;18(1):240. doi: 10.1186/s12891-017-1596-z.
10
Non-operative treatment of displaced distal radius fractures leads to acceptable functional outcomes, however at the expense of 40% subsequent surgeries.桡骨远端移位骨折的非手术治疗可带来可接受的功能结果,然而代价是后续有40%的手术率。
Orthop Traumatol Surg Res. 2017 Oct;103(6):905-909. doi: 10.1016/j.otsr.2017.01.017. Epub 2017 Apr 17.

65岁以上患者桡骨远端骨折手术与保守治疗的比较

Comparison between Surgical and Conservative Treatment for Distal Radius Fractures in Patients over 65 Years.

作者信息

Testa Gianluca, Vescio Andrea, Di Masi Paola, Bruno Giulio, Sessa Giuseppe, Pavone Vito

机构信息

Department of General Surgery and Medical Surgical Specialties-Section of Orthopaedic and Traumatology, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy.

出版信息

J Funct Morphol Kinesiol. 2019 May 17;4(2):26. doi: 10.3390/jfmk4020026.

DOI:10.3390/jfmk4020026
PMID:33467341
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7739362/
Abstract

BACKGROUND

Fractures of the distal radius (DRF) are the most common orthopedic injuries, representing one of the typical fractures indicating underlying osteoporosis. The aim of the study was to compare conservative and surgical treatment, analyzing quality of life and clinical outcome in an over 65 years old population.

METHODS

Ninety one patients were divided into two groups: the ORIF group (39 patients) underwent surgery, and the conservative group (52 patients) was treated conservatively. The clinical and functional outcomes of all patients were evaluated using Short Form 36 (SF36), Modified Mayo Wrist Score (MMWS), Disability of the Arm Shoulder Hand (DASH), and Visual Analogue Scale (VAS). Range of motion at the joint was measured and compared with the contralateral healthy wrist.

RESULTS

No significant difference was found between the overall SF36 score, DASH score, MMWS, and VAS results. Role limitation was significantly better in the surgical group ( < 0.05), and complication incidence was significantly higher ( < 0.05) in the conservative group.

CONCLUSION

The results of this study conform to recent literature, suggesting that a surgical reconstruction of the radius articular surface in an elderly population provides no clear clinical advantage. Treatment decisions must arise from careful diagnoses of the fracture and communication with the patient.

摘要

背景

桡骨远端骨折(DRF)是最常见的骨科损伤,是提示潜在骨质疏松的典型骨折之一。本研究的目的是比较保守治疗和手术治疗,分析65岁以上人群的生活质量和临床结果。

方法

91例患者分为两组:切开复位内固定(ORIF)组(39例患者)接受手术治疗,保守治疗组(52例患者)接受保守治疗。使用简明健康状况调查问卷(SF36)、改良梅奥腕关节评分(MMWS)、上肢肩手功能障碍评分(DASH)和视觉模拟量表(VAS)评估所有患者的临床和功能结果。测量关节活动范围并与对侧健康腕关节进行比较。

结果

总体SF36评分、DASH评分、MMWS和VAS结果之间未发现显著差异。手术组的角色限制明显更好(<0.05),保守组的并发症发生率明显更高(<0.05)。

结论

本研究结果与近期文献一致,表明老年人群桡骨关节面的手术重建没有明显的临床优势。治疗决策必须基于对骨折的仔细诊断以及与患者的沟通。