Gundecha Pratik T, Shevate Ishan, Salunkhe Rahul
Orthopedics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Oct 16;16(10):e71597. doi: 10.7759/cureus.71597. eCollection 2024 Oct.
Background and objective Distal radius fractures (DRFs) present unique challenges for fixation, as they often involve small, periarticular fragments that require advanced techniques to achieve proper anatomical alignment and functional recovery. This study aimed to investigate the efficacy of fragment-specific fixation in managing these fractures. Methods We conducted a longitudinal study involving 57 patients with fresh intra-articular DRFs. The participants, aged 18-80 years, were evaluated through comprehensive radiological assessments, including X-rays and CT scans, alongside clinical examinations. Ethical approval and informed consent were obtained for all procedures. Results The sample included 57 patients; 57.89% were male and 42.11% were female. The most common occupations were housewives (33.33%) and business professionals (19.30%). Injuries were nearly equally distributed between the left (47.37%) and right (52.63%) sides, with road traffic accidents accounting for 52.63% of cases. Radiological evaluations indicated significant improvements in volar tilt, from 10.38 ± 1.46 degrees postoperatively to 9.57 ± 1.67 degrees after three months, and in radial inclination, from 21.09 ± 1.72 degrees to 20.28 ± 2.04 degrees. Clinical outcomes, as measured by Green and O'Brien and Gartland and Werley scores, showed a substantial recovery, with 75.44% of patients achieving an excellent rating with no poor outcomes. Conclusions Based on our findings, fragment-specific fixation for DRFs is highly effective, leading to significant improvements in both radiological and functional outcomes. The technique helped maintain anatomical alignment and facilitated bone healing and we recommend its adoption as a standard treatment for complex DRFs. We also recommend future studies investigating its long-term outcomes and comparing this approach with other fixation methods to optimize patient care further.
背景与目的 桡骨远端骨折（DRF）在固定方面存在独特挑战，因为它们常常涉及小的关节周围骨折块，需要先进技术来实现恰当的解剖复位和功能恢复。本研究旨在探讨骨折块特异性固定在处理这些骨折中的疗效。方法 我们进行了一项纵向研究，纳入57例新鲜关节内DRF患者。参与者年龄在18 - 80岁之间，通过包括X线和CT扫描在内的全面影像学评估以及临床检查进行评估。所有程序均获得伦理批准并取得知情同意。结果 样本包括57例患者；男性占57.89%，女性占42.11%。最常见职业是家庭主妇（33.33%）和商业专业人员（19.30%）。损伤在左侧（47.37%）和右侧（52.63%）几乎均等分布，道路交通事故占病例的52.63%。影像学评估显示掌倾角有显著改善，从术后的10.38±1.46度改善至三个月后的9.57±1.67度，桡骨倾斜角从21.09±1.72度改善至20.28±2.04度。根据Green和O'Brien以及Gartland和Werley评分衡量的临床结果显示有显著恢复，75.44%的患者获得优秀评级且无不良结果。结论 根据我们的研究结果，DRF的骨折块特异性固定非常有效，在影像学和功能结果方面均有显著改善。该技术有助于维持解剖复位并促进骨愈合，我们建议将其作为复杂DRF的标准治疗方法采用。我们还建议未来开展研究，调查其长期结果，并将这种方法与其他固定方法进行比较，以进一步优化患者护理。
