Division of Plastic and Reconstructive Surgery, University of Missouri School of Medicine, Columbia, MO, United States; Department of Orthopaedic Surgery, Division of Hand Surgery, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27710, United States.
Department of Orthopaedic Surgery, Division of Hand Surgery, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27710, United States.
J Plast Reconstr Aesthet Surg. 2022 Aug;75(8):2650-2657. doi: 10.1016/j.bjps.2022.04.013. Epub 2022 Apr 22.
Long-term, high-dose, daily proton pump inhibitors (PPI) may impact outcomes associated with distal radius fractures (DRF). The hypothesis was that differences existed in patient demographics, but there existed no differences in injury patterns, interventions, post-operative complications, and patient-reported outcomes between patients not on a PPI and patients on a PPI with a DRF.
An IRB-approved, post-hoc analysis of patients with DRF from 2012 through 2018 was performed. Patients included were age ≥18 years, sustained a DRF, had completed medical and medication records, Quick Disabilities of the Arm, Shoulder and Hand (DASH) scores, Global Assessment of Functioning (GAF) scores, visual analogue scale (VAS) pain scores, and a minimum of 1-year follow-up. Patients were stratified into two cohorts. Cohort one patients had no prescription or over-the-counter PPI use (no PPI cohort). Cohort two patients had adherence to a long-term, high-dose, daily PPI (PPI cohort).
Two hundred and eighty-one DRF patients were included. Of these 281 patients, 240 were in the no PPI cohort and 41 were in the PPI cohort. Patients in the PPI cohort had more median nerve injuries (12% versus 3%, p = 0.025) and radial shaft fractures (5% versus 0%, p = 0.020), less contralateral upper extremity injuries (0% versus 4%, p = 0.001), and more post-operative nonunions (7% versus 1%, p = 0.029) compared to patients in the no PPI cohort.
Long-term, high-dose, daily PPI's may be associated with more median nerve injuries and radial shaft fractures, less contralateral upper extremity injuries, and more post-operative nonunions compared to DRF patients not on a PPI.
长期、大剂量、每日使用质子泵抑制剂（PPI）可能会影响桡骨远端骨折（DRF）相关结局。假设在未使用 PPI 的患者和使用 PPI 的 DRF 患者之间，在患者人口统计学特征方面存在差异，但在损伤类型、干预措施、术后并发症和患者报告的结局方面不存在差异。
对 2012 年至 2018 年 DRF 患者进行了一项经机构审查委员会批准的回顾性分析。纳入标准为：年龄≥18 岁，发生 DRF，完成了病历和用药记录，完成了简明上肢功能测试（Quick Disabilities of the Arm, Shoulder and Hand，DASH）评分、总体功能评估（Global Assessment of Functioning，GAF）评分、视觉模拟量表（visual analogue scale，VAS）疼痛评分，且随访时间至少 1 年。患者分为两组。一组患者无处方或非处方 PPI 使用（无 PPI 组），另一组患者长期、大剂量、每日使用 PPI（PPI 组）。
共纳入 281 例 DRF 患者，其中 240 例患者在无 PPI 组，41 例患者在 PPI 组。与无 PPI 组相比，PPI 组患者中更多出现正中神经损伤（12%比 3%，p=0.025）和桡骨干骨折（5%比 0%，p=0.020），更少出现对侧上肢损伤（0%比 4%，p=0.001），以及更多术后骨不连（7%比 1%，p=0.029）。
与未使用 PPI 的 DRF 患者相比，长期、大剂量、每日使用 PPI 可能与更多正中神经损伤和桡骨干骨折、更少对侧上肢损伤以及更多术后骨不连有关。
