Sjølander Henrik Johan, Jauffred Sune, Brix Michael, Gundtoft Per H
Department of Orthopedic Surgery, Odense University Hospital, Odense C, Denmark.
Department of Orthopedic Surgery, Zealand University Hospital, K⊘ge, Denmark.
J Wrist Surg. 2021 Apr;10(2):150-153. doi: 10.1055/s-0040-1721139. Epub 2020 Dec 26.
Following surgery, the standard regimen for fractures of the distal forearm includes radiographs taken 2-weeks postoperatively. However, it is unclear whether these radiographs have any therapeutic risks or benefits for patients. The purpose of this study is to determine the importance of radiographs taken 2-weeks after surgery on distal forearm fractures, especially if it leads to further operations, and to establish whether this practice should be continued. This is a retrospective cohort study of patients with a distal forearm fracture treated surgically with a volar locking plate at two university hospitals in Denmark. Standard aftercare at both departments is 2 weeks in a cast. Patients attend a 2-week follow-up, at which the cast is replaced with a removable orthosis and radiographs are taken. It was recorded whether these radiographs had resulted in any change of treatment in terms of further operations, prolonged immobilization, additional clinical follow-up, or additional diagnostic imaging. A total of 613 patients were included in the study. The radiographs led to a change of standard treatment for 3.1% of the patients. A second operation was required by 1.0%; 0.5% were treated with prolonged immobilization, and 1.6% had additional outpatient follow-up due to the findings on the radiographs. Additional diagnostic imaging was performed on 1.9% of the patients. The radiographs taken at the 2-weeks follow-up resulted in a change of treatment in 3.1% of the cases. Given the low cost and minimal risk of radiographs of an extremity, we concluded that the benefits outweigh the costs of routine radiographs taken 2 weeks after surgical treatment of distal forearm fractures.
手术后，前臂远端骨折的标准治疗方案包括术后2周进行X线检查。然而，这些X线检查对患者是否有任何治疗风险或益处尚不清楚。 本研究的目的是确定术后2周拍摄的X线片对前臂远端骨折的重要性，特别是其是否会导致进一步手术，并确定这种做法是否应继续。 这是一项对丹麦两家大学医院采用掌侧锁定钢板手术治疗的前臂远端骨折患者的回顾性队列研究。两个科室的标准术后护理是使用石膏固定2周。患者在术后2周进行随访，此时拆除石膏，换上可拆除的矫形器并拍摄X线片。记录这些X线片是否导致在进一步手术、延长固定时间、额外的临床随访或额外的诊断性影像学检查方面的治疗改变。 共有613名患者纳入本研究。X线片导致3.1%的患者改变了标准治疗方案。1.0%的患者需要进行二次手术；0.5%的患者接受了延长固定时间的治疗，1.6%的患者因X线片检查结果而进行了额外的门诊随访。1.9%的患者进行了额外的诊断性影像学检查。 术后2周拍摄的X线片在3.1%的病例中导致了治疗改变。鉴于四肢X线片成本低且风险极小，我们得出结论，对于前臂远端骨折手术治疗后2周进行常规X线检查，其益处大于成本。
