Kwan Stephanie A, McEntee Richard, Sodha Samir, Kwok Moody, Beredjiklian Pedro K, Tulipan Jacob E
Department of Orthopaedic Surgery, Jefferson Health - New Jersey, Stratford, New Jersey.
Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas.
J Wrist Surg. 2024 Jan 15;14(1):49-56. doi: 10.1055/s-0043-1777023. eCollection 2025 Feb.
Fractures of the distal radius that occur bilaterally are comparatively uncommon, with the incidence of these injuries and patient outcomes following different modes of treatment being unknown. This article evaluates the demographics, management, and functional outcomes of patients that sustain bilateral distal radius fractures (DRFs). We retrospectively identified 85 patients that sustained bilateral DRF and were treated at a single institution from 2016 to 2019. Thirty-four patients were treated operatively, 41 patients were treated nonoperatively, and 10 patients were treated operatively in one extremity and nonoperatively in the other. Fractures were classified by a single fellowship-trained orthopaedic hand surgeon. Range of motion (ROM) data and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were collected. Differences between the three groups with regards to demographics, mechanism of injury (MOI), and complications were recorded. The pediatric population had significantly higher energy MOIs compared to the adult population. There was no difference between the groups with regard to associated injuries or complications. The pediatric population had significantly more AO type A fractures compared to the adult population, which had a bimodal distribution of AO type A and C fractures. The pediatric population saw significantly more patients undergo nonoperative treatment. Both populations had a higher rate of operative intervention for bilateral DRF than noted in the literature for unilateral. In the adult population there were no significant differences in DASH scores between the operative and nonoperative groups. Bilateral DRFs appear to have a similar bimodal age distribution to unilateral DRF. Younger patients undergo nonoperative management more commonly than operative or mixed management. Postoperative ROM and complications appear to be equivalent across all three groups regardless of age. Level IV, Prognostic study.
双侧桡骨远端骨折相对少见，此类损伤的发生率以及不同治疗方式后的患者预后尚不清楚。本文评估了双侧桡骨远端骨折（DRF）患者的人口统计学特征、治疗方法及功能预后。我们回顾性纳入了2016年至2019年在单一机构接受治疗的85例双侧DRF患者。34例患者接受手术治疗，41例患者接受非手术治疗，10例患者一侧肢体接受手术治疗，另一侧肢体接受非手术治疗。骨折由一名接受过 fellowship 培训的骨科手外科医生进行分类。收集了活动范围（ROM）数据以及手臂、肩部和手部快速残疾评定量表（QuickDASH）评分。记录了三组在人口统计学特征、损伤机制（MOI）和并发症方面的差异。与成人相比，儿童人群的损伤能量MOI显著更高。各组在合并损伤或并发症方面无差异。与成人相比，儿童人群的AO A型骨折明显更多，而成人人群的AO A型和C型骨折呈双峰分布。儿童人群接受非手术治疗的患者明显更多。两组双侧DRF的手术干预率均高于文献报道的单侧DRF。在成人人群中，手术组和非手术组的DASH评分无显著差异。双侧DRF似乎与单侧DRF具有相似的双峰年龄分布。年轻患者比手术或混合治疗更常接受非手术治疗。无论年龄如何，所有三组术后的ROM和并发症似乎相当。IV级，预后研究。
