Carney John, Bigach Stephen, Goedderz Cody, Gerlach Erik, Marx Jeremy, Kalainov David
Department of Orthopaedic Surgery, Feinberg School of Medicine of Northwestern University, Chicago, Illinois.
J Wrist Surg. 2023 Nov 29;14(1):57-62. doi: 10.1055/s-0043-1777022. eCollection 2025 Feb.
The purpose of this study was to describe the volar plate-suture fixation technique for augmented repair of volar rim fractures of the distal radius and to report clinical outcomes and radiographic findings. Twenty-one patients treated with volar plate-suture fixation were retrospectively reviewed. Outcomes of interest included pain, joint motion, grip strength, surgical complications, additional surgeries, and radiographic parameters. Final follow-up office visits from surgery averaged 30.8 weeks (range 6-175 weeks). There was no report of residual wrist pain in most cases. Forearm and wrist motion measurements were within functional ranges and grip strength measurements averaged 63 ± 21% of the contralateral hand. There were no cases of infection, wound dehiscence, nerve injury, or nonunion. Hardware removal was performed in four patients for wrist pain attributed to the fixation implant(s). One patient underwent a wrist fusion for treatment of painful traumatic wrist arthritis. Failure of the fracture fixation construct to hold the carpus occurred in two patients. Changes in radiocarpal and intercarpal angles averaged less than 4 degrees and loss of articular reduction averaged less than 1 mm, although with relatively high standard deviations. Suture fixation of volar rim fractures of the distal radius may be a useful technique in augmenting volar plate fracture fixation. Some loss of early postoperative fracture alignment should be expected. IV, case series.
本研究的目的是描述用于增强修复桡骨远端掌侧缘骨折的掌侧板-缝线固定技术，并报告临床结果和影像学表现。对21例行掌侧板-缝线固定治疗的患者进行回顾性分析。关注的结果包括疼痛、关节活动度、握力、手术并发症、再次手术以及影像学参数。手术至最终随访门诊的平均时间为30.8周（范围6 - 175周）。大多数病例无残留腕部疼痛的报告。前臂和腕部活动度测量值在功能范围内，握力测量值平均为对侧手的63±21%。无感染、伤口裂开、神经损伤或骨不连病例。4例患者因固定植入物导致的腕部疼痛而取出内固定物。1例患者因创伤性腕关节炎疼痛接受了腕关节融合术。2例患者出现骨折固定结构无法固定腕骨的情况。桡腕关节和腕间关节角度变化平均小于4度，关节复位丢失平均小于1毫米，尽管标准差相对较高。桡骨远端掌侧缘骨折的缝线固定可能是增强掌侧板骨折固定的一种有用技术。术后早期骨折对线会有一定程度的丢失。IV，病例系列。
