Department of Orthopedics and Traumatology, Yozgat Bozok University Faculty of Medicine, Yozgat-Turkey.
Ulus Travma Acil Cerrahi Derg. 2021 Nov;27(6):684-689. doi: 10.14744/tjtes.2020.56345.
In this study, we aimed to compare the radiological, clinical and functional results of volar radius locking plate, and K-wire augmented bridging external fixator (BEF) treatments that applied in intra-articular distal radius fractures.
Between May 2016 and January 2019, 162 patients who met the inclusion criteria of 23-C2 and 23-C3 according to the AO/OTA classification who operated in our clinic were evaluated retrospectively. 78 patients (37 males, 41 females, mean age 49.92) were fixated with K wire augmented BEF and 84 patients (41 males, 43 females, mean age 46.81) were fixated with volar locking plate (VLP). Demographic (age, gender, type of trauma, and follow-up time), radiological (radial inclination, radial height, volar tilt, and fracture healing time), and clinical and functional (range of motion [ROM], grip strength, Quick Dash, Green O'Brien and Mayo scores) data of the patient groups were recorded and compared statistically.
There was no significant difference between the patient groups in terms of functional scoring systems. Radiologically, radial inclination, and radial length were significantly better in the volar plate group. In terms of joint ROM, flexion, extension, pronation, and supination movements were significantly better in the VLP group. Sudek atrophy incidence and loss of grip strength were higher in BEF group. Mean time of union was significantly shorter in the BEF group.
Successful results can be obtained in both treatment methods. However, VLP treatment provides better joint ROM and lower complication rates compared to BEF treatment.
本研究旨在比较掌侧锁定钢板和克氏针增强桥接外固定器(BEF)治疗关节内桡骨远端骨折的影像学、临床和功能结果。
回顾性分析 2016 年 5 月至 2019 年 1 月在我院接受治疗的符合 AO/OTA 分类 23-C2 和 23-C3 纳入标准的 162 例患者。78 例患者(37 例男性,41 例女性,平均年龄 49.92 岁)采用克氏针增强 BEF 固定,84 例患者(41 例男性,43 例女性,平均年龄 46.81 岁)采用掌侧锁定钢板(VLP)固定。记录并比较两组患者的一般资料(年龄、性别、创伤类型和随访时间)、影像学资料(桡骨倾斜度、桡骨高度、掌倾角和骨折愈合时间)和临床及功能资料(关节活动度、握力、快速短跑、Green-O'Brien 和 Mayo 评分)。
在功能评分系统方面,两组患者无显著差异。影像学方面,掌侧钢板组的桡骨倾斜度和桡骨长度明显更好。在关节活动度方面,VLP 组的掌屈、背伸、旋前和旋后运动明显更好。BEF 组的苏代克萎缩发生率和握力丧失较高。BEF 组的愈合时间明显缩短。
两种治疗方法都能取得满意的效果。然而,与 BEF 治疗相比,VLP 治疗提供了更好的关节活动度和更低的并发症发生率。