van Veelen Nicole M, Horvat Matija, Link Björn-Christian, van de Wall Bryan J M, Beeres Frank J P
Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Spitalstrasse 166000, Lucerne, Switzerland.
Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005, Lucerne, Switzerland.
Eur J Trauma Emerg Surg. 2025 May 22;51(1):217. doi: 10.1007/s00068-025-02876-w.
The aim of this study was to compare the radiological outcome of patients with distal radius fractures stabilized with a volar plate using either locking screws or pegs.
MATERIAL & METHODS: For this retrospective study all adult patients that received volar plating of a distal radius fracture at a trauma center between 06/2019 and 06/2022 were eligible for inclusion. Only patients who received an implant allowing both locking pegs and screws were included. Primary outcome was radiological loss of reduction at the 6-week and at the 12-month follow-up. Secondary outcomes were duration of surgery, implant removal, fracture union and complications.
Fourty-nine patients treated with pegs and 39 with screws were included. Patient demographics were comparable, however there were more complex fractures in the peg group. There was no significant difference in the occurrence of radiological loss of reduction between the groups at 6 weeks or 12 months (p = 1). Patients treated with pegs were more frequently operated upon by experienced surgeons while screws were more often used by more junior staff. The duration of surgery was longer for patients who received screws (p = 0.003). Union was achieved in all fractures for which a 12-month x-ray was available. There was no significant difference in implant removal rate or other complications.
Regarding secondary loss of reduction both locking pegs and screws show similar results. Considering the potential benefits of pegs, such as the smooth surface which may reduce the risk of joint penetration, pegs are a viable alternative to screws.
本研究旨在比较使用锁定螺钉或栓钉的掌侧钢板固定桡骨远端骨折患者的放射学结果。
对于这项回顾性研究，2019年6月至2022年6月期间在创伤中心接受桡骨远端骨折掌侧钢板固定的所有成年患者均符合纳入标准。仅纳入接受同时允许使用锁定栓钉和螺钉的植入物的患者。主要结局是在6周和12个月随访时复位丢失的放射学情况。次要结局包括手术时间、植入物取出、骨折愈合和并发症。
纳入49例使用栓钉治疗的患者和39例使用螺钉治疗的患者。患者人口统计学特征具有可比性，然而栓钉组的骨折更复杂。两组在6周或12个月时复位丢失的发生率无显著差异（p = 1）。使用栓钉治疗的患者更常由经验丰富的外科医生进行手术，而螺钉则更多由资历较浅的工作人员使用。接受螺钉治疗的患者手术时间更长（p = 0.003）。所有有12个月X线片的骨折均实现愈合。植入物取出率或其他并发症无显著差异。
关于继发性复位丢失，锁定栓钉和螺钉显示出相似的结果。考虑到栓钉的潜在益处，如光滑表面可能降低关节穿透风险，栓钉是螺钉的可行替代方案。
