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桡骨远端骨折锁定钢板固定术后我们是否需要标准化的术后X线片——对664例患者的回顾性分析

Do we need standardized postoperative radiographs after locking plate fixation of distal radius fractures - A retrospective analysis of 664 patients.

作者信息

Ketter V, Kiehne C, Frink M, Aigner R, Ruchholtz S, Lenz J

机构信息

Center for Orthopaedics and Trauma Surgery, Philipps-University Marburg; University Hospital Giessen and Marburg GmbH, Location Marburg, Baldingerstraße, D-35043, Marburg, Germany.

Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Location, Lübeck, Germany.

出版信息

Arch Orthop Trauma Surg. 2024 Dec 12;145(1):28. doi: 10.1007/s00402-024-05631-9.

Abstract

INTRODUCTION

After surgical treatment of fractures of the distal radius, radiographs in 2 planes are routinely performed postoperatively as a standard procedure to verify anatomic reduction and implant positioning. However, the postoperative radiological examinations rarely has a consequence. Therefore, the purpose of this study was to evaluate the frequency of treatment plan changes based on standardized postoperative radiographs. Secondarily, abnormalities, already being present in the intraoperative radiographs, were examined.

METHODS

Between 2015 and 2019 a total of 664 consecutive patients who underwent open reduction and internal fixation of a distal radius were evaluated in a retrospective study.

RESULTS

The median age was 60 (range 92 - 16 years). Overall, a treatment plan change was detected in 20 patients. After standardized postoperative radiographs a CT scan was performed in 16 patients and 14 patients underwent early operative revision; in only four of these cases, the revision could be attributed to the postoperative radiograph.

CONCLUSION

Considering the low incidence of treatment plan changes, routinely performed radiographs after surgical treatment of distal radius fractures must be critically questioned.

摘要

引言

桡骨远端骨折手术治疗后,作为标准程序,术后常规进行两个平面的X线检查以验证解剖复位和植入物位置。然而,术后影像学检查很少产生影响。因此,本研究的目的是评估基于标准化术后X线片改变治疗计划的频率。其次,检查术中X线片中已存在的异常情况。

方法

在一项回顾性研究中,对2015年至2019年间连续664例行桡骨远端切开复位内固定术的患者进行了评估。

结果

中位年龄为60岁(范围92 - 16岁)。总体而言,在20例患者中检测到治疗计划改变。标准化术后X线片后,16例患者进行了CT扫描,14例患者接受了早期手术翻修;在这些病例中,只有4例翻修可归因于术后X线片。

结论

考虑到治疗计划改变的发生率较低,桡骨远端骨折手术治疗后常规进行的X线检查必须受到质疑。

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