Haider Sajjad, Awais Muhammad Zarak, Salik Eman, Iqbal Muhammad Tahir
Sajjad Haider, MS. Department of Orthopedic Surgery, Mayo Hospital, Lahore, Pakistan.
Muhammad Zarak Awais, MBBS. Department of Orthopedic Surgery, Mayo Hospital, Lahore, Pakistan.
Pak J Med Sci. 2024 Sep;40(8):1797-1801. doi: 10.12669/pjms.40.8.8799.
To compare the functional and radiological outcomes of treatment of volar Barton's fractures using T plate with and without distal end screws.
This randomized control trial was conducted at the department of Orthopedics, Mayo Hospital, Lahore, Pakistan from December 2021 to May 2022. Total 60 patients (30 in each group) were randomly allocated to either group A (T-Plate with distal end screws) or B (T-Plate without distal end screws). Patients were followed up on day-0, day-14, day-28 and day-90. Assessments of patients were done by Green O'Brien Score for pain, Modified Warden Score for callus formation on radiographs at 12-weeks of follow-up and Stewart Score for displacement of fracture.
At 90 day, significant difference was seen in Green O'Brien Score (Excellent score: Group-A: 80% vs. Group-B: 90%, p=0.278) while Stewart scores remained comparable (Excellent Score: Group-A: 93.33% vs. Group-B: 96.67%, p=0.221) between treatment groups. Fracture healing assessed with Modified Warden score for score 4 did not show significant difference between both groups at 90 day. i.e. (Group-A: 96.67% vs. Group-B: 96.67%). However, callus formation assessed with Modified Warden score for score 3 showed significant differences between groups at 90 day. i.e. (Group-A: 53.33% vs. Group-B: 86.67%, p=0.001).
Both treatment approaches appear to yield comparable outcomes in terms of clinical assessment, Stewart scores, and fracture healing, with a potential advantage for T-plate without distal end screw in callus formation at the 90th day.Trial registration: IRCT20221231056999N1.
比较使用带远端螺钉和不带远端螺钉的T形钢板治疗掌侧巴顿骨折的功能和影像学结果。
本随机对照试验于2021年12月至2022年5月在巴基斯坦拉合尔梅奥医院骨科进行。总共60例患者（每组30例）被随机分配到A组（带远端螺钉的T形钢板）或B组（不带远端螺钉的T形钢板）。在第0天、第14天、第28天和第90天对患者进行随访。通过格林·奥布赖恩疼痛评分、随访12周时X线片上骨痂形成的改良沃登评分以及骨折移位的斯图尔特评分对患者进行评估。
在第90天，格林·奥布赖恩评分存在显著差异（优秀评分：A组：80% vs. B组：90%，p = 0.278），而治疗组之间的斯图尔特评分仍具有可比性（优秀评分：A组：93.33% vs. B组：96.67%，p = 0.221）。用改良沃登评分评估的骨折愈合情况在第90天两组之间未显示出显著差异。即（A组：96.67% vs. B组：96.67%）。然而，用改良沃登评分评估的骨痂形成情况在第90天两组之间存在显著差异。即（A组：53.33% vs. B组：86.67%，p = 0.001）。
两种治疗方法在临床评估、斯图尔特评分和骨折愈合方面似乎产生了可比的结果，在第90天不带远端螺钉的T形钢板在骨痂形成方面可能具有优势。试验注册号：IRCT20221231056999N1。
