Ji Jiaqing, Wang Yanben, Ma Dang, Yin Ziyue, Abudureyimu Abudukeremu, Chen Kai, Yuan Feng, Fan Jian
Department of Orthopedics, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
Arch Orthop Trauma Surg. 2024 Dec 12;145(1):11. doi: 10.1007/s00402-024-05630-w.
This study aimed to explore the effect of displaced dorsal rim fragments under defined size threshold on the clinical outcome.
Forty patients with an acute distal radius fracture accompanied by a dorsal rim fragment comprising less than 10% of the radiocarpal articular surface were included in the study. The size of the dorsal rim fragment was measured by axial CT scans and three-dimensional (3D) CT scans, and the correlation between these two methods was analyzed to evaluate the reliability of axial CT scan measurements. Based on the displacement (> 2 mm) of dorsal rim fragments measured by sagittal CT scans, the patients were divided into two groups, namely the displaced group (17 patients) and the control group (23 patients). The radiographic parameters and wrist function at final follow-up were compared between the two groups.
Mean radiocarpal joint involvement of the included dorsal rim fragment was 8.6%±1.0% (range, 5.7-9.9%) assessed by axial CT scans. There was a strong correlation in the radiocarpal articular involvement of the dorsal rim fragment between axial CT scans and 3D CT models (correlation coefficient r = 0.819). Mean displacement of the dorsal rim fragment was 2.2 (2.1, 2.5) mm (range, 2.0-3.2) in the displaced group and 0.9 (0, 1.5) mm (range, 0-1.9) in the control group. There were no significant differences in any radiographic parameter and wrist function between the two groups.
For dorsal rim fragments comprising less than 10% of the radiocarpal articular surface in distal radius fracture, mild displacement does not significantly affect the recovery of wrist function.
本研究旨在探讨特定尺寸阈值以下的桡骨背侧缘骨折块移位对临床结局的影响。
本研究纳入了40例急性桡骨远端骨折伴桡腕关节面背侧缘骨折块小于10%的患者。通过轴向CT扫描和三维（3D）CT扫描测量背侧缘骨折块的大小，并分析这两种方法之间的相关性，以评估轴向CT扫描测量的可靠性。根据矢状面CT扫描测量的背侧缘骨折块移位情况（>2mm），将患者分为两组，即移位组（17例）和对照组（23例）。比较两组患者末次随访时的影像学参数和腕关节功能。
通过轴向CT扫描评估，纳入的背侧缘骨折块平均累及桡腕关节的比例为8.6%±1.0%（范围为5.7-9.9%）。轴向CT扫描与3D CT模型测量的背侧缘骨折块累及桡腕关节的比例之间存在强相关性（相关系数r=0.819）。移位组背侧缘骨折块的平均移位为2.2（2.1，2.5）mm（范围为2.0-3.2），对照组为0.9（0，1.5）mm（范围为0-1.9）。两组患者在任何影像学参数和腕关节功能方面均无显著差异。
对于桡骨远端骨折中累及桡腕关节面小于10%的背侧缘骨折块，轻度移位对腕关节功能的恢复无显著影响。
