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桡骨远端骨折治疗中社会人口统计学和影像学特征的比较:手外科医生与非专科医生

Comparison of Sociodemographic and Radiographic Features in Distal Radio Fracture Treatment: Hand Surgeons versus Non-specialists.

作者信息

Veiga Rafael Bulyk, Hobi Renê, Marot Ricardo Pereira, Schuroff Gustavo Zeni, Sobania Roberto Luiz, Kuhn Ivan Killing, Faccioni Ana Lucia Campos

机构信息

Departamento de Ortopedia e Traumatologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.

Departamento de Ortopedia e Traumatologia, Hospital do Trabalhador, Universidade Federal do Paraná, Curitiba, PR, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Mar 21;59(1):e46-e53. doi: 10.1055/s-0043-1776017. eCollection 2024 Feb.

Abstract

This study evaluated sociodemographic and radiographic features of patients with distal radial fractures treated at a trauma hospital in southern Brazil, comparing those treated by hand surgery specialists (group 1) and non-specialists (group 2).  This study consists of a retrospective cohort of 200 patients treated in 2020. After reviewing medical records and radiographs, the following parameters were analyzed: age, gender, trauma mechanism, laterality, associated comorbidities and fractures, fracture classification (AO), radial height, radial inclination, and volar inclination. Comparison of the two groups used the Student t-test, chi-square test, or Fisher exact test.  Most subjects were women (54%), sustained low-energy traumas (58%), and were left-handed (53%). Group 1 had a lower mean age (50.2 years); most of their subjects sustained high-energy trauma (54%) and had type C fractures (73%); type A fractures prevailed in group 2 (72%). Radiographs showed a significant difference regarding the mean radial inclination (21.5° in group 1 and 16.5° in group 2 [  < 0.001] in women, and 21.3° in group 1 and 17° in group 2 [  < 0.001] in men) and volar inclination (10.1° and 12.8° in groups 1 and 2, respectively [  < 0.001]). In addition, the absolute number of cases with reestablished anatomical parameters per the three evaluated variables was also significantly different; all parameters were better in group 1.  Hand surgeons treated the most severe fractures and had the best radiographic outcomes.

摘要

本研究评估了巴西南部一家创伤医院治疗的桡骨远端骨折患者的社会人口统计学和影像学特征,比较了由手外科专科医生治疗的患者(第1组)和非专科医生治疗的患者(第2组)。 本研究包括2020年接受治疗的200例患者的回顾性队列研究。在查阅病历和X光片后,分析了以下参数:年龄、性别、创伤机制、侧别、相关合并症和骨折情况、骨折分类(AO)、桡骨高度、桡骨倾斜度和掌侧倾斜度。两组之间的比较采用Student t检验、卡方检验或Fisher精确检验。 大多数受试者为女性(54%),遭受低能量创伤(58%),且为左利手(53%)。第1组的平均年龄较低(50.2岁);他们的大多数受试者遭受高能量创伤(54%)且为C型骨折(73%);第2组中A型骨折占主导(72%)。X光片显示,平均桡骨倾斜度存在显著差异(女性中,第1组为21.5°,第2组为16.5°[<0.001];男性中,第1组为21.3°,第2组为17°[<0.001]),掌侧倾斜度也存在显著差异(第1组和第2组分别为10.1°和12.8°[<0.001])。此外,根据三个评估变量重新建立解剖参数的病例绝对数也存在显著差异;第1组的所有参数均更佳。 手外科医生治疗的骨折最为严重,影像学结果也最佳。

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