Biondi Marco, Poggetti Andrea, Fagetti Alessandro, Di Maro Agostino, Bigazzi Prospero, Pfanner Sandra, Lauri Giulio
Surgery and Reconstructive Microsurgery Unit of the Hand, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Microsurgery and Hand Surgery Unit, ASST Sette Laghi, Varese, Italy.
Eur J Trauma Emerg Surg. 2022 Dec;48(6):4577-4584. doi: 10.1007/s00068-021-01710-3. Epub 2021 May 26.
Volar rim fractures of the distal radius are a spectrum of pathology that must be well identified and treated to achieve good outcomes and avoid surgical failures. New devices of fragment specific fixation have been developed during the last decades to fix this fragment. The purpose of this retrospective study was to evaluate the ability of APTUS wrist distal radius system to securely fix different types of volar rim fractures.
Patients with at least 1 year of follow-up and a preoperative CT-scan evaluation of the fracture pattern were included in the study. Clinical, radiological and functional outcomes were assessed.
Sixty-eight patients with an average follow-up of 34, 1 months (12-61) were included in the study. There were no clinical and radiological complications, including loss of reduction, device failure and tendon ruptures. No patients required hardware removal. Wrist range of motion in flexion-extension averaged 96°, while in pronation-supination 144°. At final follow-up mean visual analogue scale pain was 1,8. Questionnaires, as dissabilities of the arm, shouldder and hand (DASH) score and patient-related wrist evolution (PRWE) score were 6,6 and 3 respectively. Grip strenght measured 86% compared to the normal side.
APTUS wrist presents a versatile set of fragment specific fixation plates able to easily and securely fix all types of volar rim fracture. The system can be used with other devices without any kind of interference between them. When correctly placed and used with the right indications, no late complications can be recorded.
桡骨远端掌侧缘骨折是一系列病理情况，必须得到充分识别和治疗，以取得良好疗效并避免手术失败。在过去几十年中，已开发出用于固定该骨折块的新型特定骨折块固定装置。本回顾性研究的目的是评估APTUS腕部桡骨远端系统牢固固定不同类型掌侧缘骨折的能力。
本研究纳入了至少随访1年且术前进行了骨折模式CT扫描评估的患者。对临床、影像学和功能结果进行了评估。
本研究纳入了68例患者，平均随访34.1个月（12 - 61个月）。未出现临床和影像学并发症，包括复位丢失、器械故障和肌腱断裂。无患者需要取出内固定物。腕关节屈伸活动度平均为96°，旋前旋后活动度平均为144°。末次随访时，视觉模拟评分法疼痛平均评分为1.8。问卷调查方面，手臂、肩部和手部功能障碍（DASH）评分以及患者相关的腕关节进展（PRWE）评分分别为6.6和3。握力与健侧相比为86%。
APTUS腕部提供了一套通用的特定骨折块固定钢板，能够轻松、牢固地固定所有类型的掌侧缘骨折。该系统可与其他器械配合使用，彼此之间无任何干扰。在正确放置并符合合适适应证使用时，不会出现晚期并发症。
