Hitit Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, 19040 Çorum, Türkiye.
Jt Dis Relat Surg. 2023;34(1):108-114. doi: 10.52312/jdrs.2023.856. Epub 2022 Dec 27.
The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments.
Between May 2020 and April 2021, a total of 29 patients (13 males, 16 females; mean age: 52.3±13.0 years; range, 30 to 78 years) who were operated and followed in our clinic for AO A2 and A3 distal radius fractures were included in this prospective study. Surface ultrasound (US) imaging was made to the dorsal sides of both wrists of the operated patients at different timepoints postoperatively. The length of screws with radius dorsal cortex penetration and the presence of tendinitis were recorded.
In 15 of 23 patients, the presence of 29 protruding screws was accompanied by tendinitis and, in eight patients, no tendinitis was observed, despite the partial protrusion of screws. A statistically significant correlation was found between the screw protrusion and presence of tendinitis (p<0.05). The number of protruding screws and tendinitis were seen mostly in the second compartment. There was a statistically significant correlation between the protruding screw length of >1.6 mm and the presence tendinitis (p<0.05).
Dorsal cortex screw protrusions in the application of volar plate for distal radius fractures can cause tendinitis. Screw protrusions occur more frequently in the second compartment and the development of tendinitis in this compartment is associated with a screw length of >1.6 mm. Screw penetration can be easily identified with intraoperative US to prevent tendinitis and potential tendon ruptures.
本研究旨在评估所有间室中背侧皮质突出螺钉长度与伸肌腱损伤之间的关系。
在 2020 年 5 月至 2021 年 4 月期间，共有 29 名患者（13 名男性，16 名女性；平均年龄：52.3±13.0 岁；年龄范围 30 至 78 岁）因 AO A2 和 A3 桡骨远端骨折在我们诊所接受手术和随访，被纳入本前瞻性研究。对术后不同时间点的 29 例手术患者的双侧腕背侧进行表面超声（US）成像。记录螺钉穿透桡骨背侧皮质的长度和腱鞘炎的存在情况。
在 23 例患者中，15 例有 29 枚突出螺钉，伴有腱鞘炎，而在 8 例患者中，尽管螺钉部分突出，但未见腱鞘炎。螺钉突出与腱鞘炎的存在之间存在统计学显著相关性（p<0.05）。第二间室中可见到更多的突出螺钉和腱鞘炎。突出螺钉长度>1.6mm 与腱鞘炎的存在之间存在统计学显著相关性（p<0.05）。
在桡骨远端骨折掌侧钢板应用中，背侧皮质螺钉突出可引起腱鞘炎。第二间室中螺钉突出更为常见，且该间室腱鞘炎的发生与螺钉长度>1.6mm 相关。术中 US 可轻易识别螺钉穿透，以预防腱鞘炎和潜在的肌腱断裂。
