Ghafoor Haval, Haefeli Mathias, Steiger Regula, Honigmann Philipp
Hand Surgery, Kantonsspital Baselland, Liestal, Switzerland.
Hand Surgery, Kantonsspital Graubünden, Chur, Switzerland.
J Wrist Surg. 2021 Oct 1;11(2):134-144. doi: 10.1055/s-0041-1735839. eCollection 2022 Apr.
To report the radiologic outcome and rate of complications of open reduction and internal fixation (ORIF) using a dorsal plate fixation of simple and complex distal radius fractures in adult patients. Patients treated with dorsal ORIF of simple and complex distal radius fractures between December 2008 and April 2013 were included in this single-center retrospective study. Type of fracture, radiographic measurements, and complications were documented. One-hundred and sixty-six patients/fractures were included. Restoration of radial inclination (22° ± 3°) was achieved in 38%. Radial height (14 ± 1 mm) was least likely to be restored to normal values postoperative in 25%. Normal ulnar variance (0.7 ± 1.5 mm) could be observed in 60% and adequate volar tilt (11° ± 5°) was achieved in 50% at final follow-up. We observed one loss of reduction in an AO type C2 fracture and a total of 15 nonimplant-related minor clinical complications. Our radiographic findings after dorsal plating are comparable to those published on volar plating. The changes in radial height and volar tilt could be attributed to projection-related differences in the radiographs and did not signify a loss of reduction in all cases. Dorsal plating of distal radius fractures is safe and remains an important approach in the treatment of complex distal radius fractures. Complications in our study were even less compared to those reported in the literature. This is a Type IV study. The level of experience of surgeons is III-V.
报告成年患者单纯性和复杂性桡骨远端骨折采用背侧钢板固定切开复位内固定(ORIF)的放射学结果及并发症发生率。
纳入2008年12月至2013年4月间接受单纯性和复杂性桡骨远端骨折背侧ORIF治疗的患者进行单中心回顾性研究。记录骨折类型、影像学测量结果及并发症情况。
共纳入166例患者/骨折。38%的患者桡骨倾斜度恢复至(22°±3°)。25%的患者桡骨高度(14±1mm)术后最不可能恢复至正常值。末次随访时,60%的患者尺骨变异正常(0.7±1.5mm),50%的患者掌倾角合适(11°±5°)。我们观察到1例AO C2型骨折复位丢失,共15例与植入物无关的轻微临床并发症。
我们背侧钢板固定后的影像学结果与掌侧钢板固定的报道结果相当。桡骨高度和掌倾角的变化可能归因于X线片上与投影相关的差异,并非在所有病例中都意味着复位丢失。
桡骨远端骨折的背侧钢板固定是安全的,仍然是治疗复杂性桡骨远端骨折的重要方法。与文献报道相比,我们研究中的并发症更少。
这是一项IV型研究。
外科医生的经验水平为III - V级。