Baek Jong-Hun, Lee Jae-Hoon, Ku Ki-Hyeok
Department of Orthopedic Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea.
Department of Orthopedic Surgery, Yeson Hospital, Bucheon 14555, Republic of Korea.
J Clin Med. 2023 Sep 16;12(18):6003. doi: 10.3390/jcm12186003.
Radial shortening after distal radius fracture causes ulnar impaction, and a mild reduction loss of radial height occurs even after volar locking plate fixation. This study aimed to determine whether preoperative ulnar-sided sclerosis affects clinical outcomes after volar locking plate fixation for distal radius fracture (DRF).
Among 369 patients who underwent volar locking plate fixation for DRF, 18 with preoperative ulnar-sided sclerosis of the lunate were included in Group A and compared to a 1:4 age-, sex- and fracture-pattern-matched cohort without sclerosis (72 patients, Group B). The visual analog scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and grip strength were assessed as clinical outcomes. Ulnar variance (UV), radial inclination, radial length, and volar tilt at two weeks after surgery and the final follow-up were measured as radiographic outcomes.
The mean VAS and DASH scores and grip strength did not differ between the two groups. The mean UV at two weeks after surgery and the last follow-up was significantly higher in Group A. The mean changes in UV were +0.62 mm in Group A and +0.48 mm in Group B. There were no significant intergroup differences. Neither UV nor its changes showed any association with DASH and VAS scores.
Preoperative ulnar-sided sclerosis of the lunate did not affect clinical outcomes after volar locking plate fixation, even if UV increased postoperatively.
桡骨远端骨折后桡骨短缩会导致尺骨撞击，即使采用掌侧锁定钢板固定后，桡骨高度也会出现轻度丢失。本研究旨在确定术前尺侧硬化是否会影响桡骨远端骨折（DRF）掌侧锁定钢板固定后的临床疗效。
在369例行DRF掌侧锁定钢板固定的患者中，18例术前存在月骨尺侧硬化的患者纳入A组，并与年龄、性别和骨折类型匹配的无硬化队列（72例患者，B组）进行1:4对照。将视觉模拟量表（VAS）、上肢、肩部和手部功能障碍（DASH）评分及握力作为临床疗效指标。将术后两周及末次随访时的尺骨变异（UV）、桡骨倾斜度、桡骨长度和掌倾角作为影像学指标。
两组患者的平均VAS和DASH评分及握力无差异。A组术后两周及末次随访时的平均UV显著更高。A组UV的平均变化为+0.62mm，B组为+0.48mm。两组间无显著差异。UV及其变化均与DASH和VAS评分无相关性。
即使术后UV增加，术前月骨尺侧硬化也不会影响桡骨远端骨折掌侧锁定钢板固定后的临床疗效。
