Department of Orthopedic Surgery, Norrköping, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden.
PLoS One. 2024 Nov 12;19(11):e0307763. doi: 10.1371/journal.pone.0307763. eCollection 2024.
Fractures of the distal radius are the most common fractures of the upper extremity. The choice of surgical method has been debated and studies show that short-term differences, in favour of volar locking plates, are indistinguishable at 1 year follow-up. Few studies have investigated long-term outcomes beyond one year. The aim of this study was to investigate long-term (6-10 years) patient-reported outcomes after distal radius fracture surgery, and to determine how fracture pattern/complexity (Buttazzoni fracture type) affects the results.
303 patients surgically treated for a distal radius fracture, from 2012-2016 were included. The questionnaires used were PRWE, Quick-DASH and EQ-5D. Previous studies have shown that fracture type influences the choice of surgical method and therefore fracture type was adjusted for in the statistical analysis.
We found that patients treated with K-wires had significantly better Quick-DASH scores (p <0.05) and a lower degree of pain (PRWE pain scale) (p <0.05) than patients treated with volar locking plates. There was no difference between the two groups regarding the remaining outcome measures for any Buttazzoni type of fracture.
On the basis of these results, K-wires can be considered an equivalent option to locking plates because of equal or better long-term outcomes, lower costs, and shorter operation times.
桡骨远端骨折是上肢最常见的骨折。手术方法的选择一直存在争议，研究表明，在 1 年随访时，掌侧锁定钢板短期效果较好，但长期效果无明显差异。很少有研究在 1 年以上的时间内调查长期结果。本研究旨在调查桡骨远端骨折手术后 6-10 年的患者报告结果，并确定骨折类型/复杂性（Buttazzoni 骨折类型）如何影响结果。
纳入了 2012-2016 年接受桡骨远端骨折手术治疗的 303 例患者。使用的问卷包括 PRWE、Quick-DASH 和 EQ-5D。先前的研究表明，骨折类型会影响手术方法的选择，因此在统计分析中对骨折类型进行了调整。
我们发现，与接受掌侧锁定钢板治疗的患者相比，接受克氏针治疗的患者的 Quick-DASH 评分明显更好（p<0.05），疼痛程度（PRWE 疼痛量表）更低（p<0.05）。对于任何 Buttazzoni 类型的骨折，两组在其他结果测量方面均无差异。
基于这些结果，克氏针可以被认为是锁定钢板的等效选择，因为其具有同等或更好的长期结果、更低的成本和更短的手术时间。
