Nazari Roozbeh, Mousavi Shahnam, Fakoor Mohammad, Dargah Arash Hassanpour, Mayan Behnam Hamiat, Taheri Homa, Mousavinezhad Seyedeh Maryam, Senobari Nahid, Gooshvar Mehrdad, Ebrahimi Pouya
Cardiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Orthopedic Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Sci Rep. 2025 May 31;15(1):19147. doi: 10.1038/s41598-025-04001-8.
Closed reduction with external fixation (CREF) and percutaneous pinning (CRPP) are commonly used surgical interventions to treat distal radius fractures. However, there is no consensus regarding the optimal management of these types of fractures. Therefore, this study aimed to compare these treatments' clinical and radiological outcomes in two subgroups of distal radius fractures. The patients who were ≥ 18 and were referred for the diagnosis of type I and III (Fernandez) distal radius fractures were treated with one of these two methods, which have been evaluated through a retrospective analysis of the medical records. A total of 244 patients were divided into CREF treatment (n = 122) and control treatment (n = 122). These patients' radiological, clinical, functional, and incidence rates of complications (over-distraction, radial neuropathy, and deep or superficial infection) were compared to analyze each method's positive and negative aspects. This study showed that patients in the PP group reported significantly less pain than those in the EF group (P-value < 0.05). The PP group scored lower in the specific and general activities categories, significantly reducing Patient-Rated Wrist Evaluation (PRWE). Although the CREF group had greater radius shortening, the difference was not statistically significant. Notably, the CREF group exhibited a significantly higher incidence of complications. Percutaneous pinning proved to be a more effective method for treating distal radius type I and III fractures. Compared to those treated with external fixation, patients experienced fewer post-treatment complications, lower pain levels, and less difficulty in daily activities.
闭合复位外固定（CREF）和经皮穿针固定（CRPP）是治疗桡骨远端骨折常用的手术干预方法。然而，对于这类骨折的最佳治疗方案尚无共识。因此，本研究旨在比较这两种治疗方法在桡骨远端骨折两个亚组中的临床和影像学结果。年龄≥18岁且因I型和III型（费尔南德斯分型）桡骨远端骨折前来诊断的患者采用这两种方法之一进行治疗，并通过对病历的回顾性分析进行评估。总共244例患者被分为CREF治疗组（n = 122）和对照组（n = 122）。比较这些患者的影像学、临床、功能及并发症（过度牵引、桡神经病变以及深部或浅部感染）发生率，以分析每种方法的优缺点。本研究表明，穿针固定组患者报告的疼痛明显少于外固定组（P值<0.05）。穿针固定组在特定活动和一般活动类别中的得分较低，显著降低了患者腕关节评估量表（PRWE）评分。虽然CREF组桡骨短缩更明显，但差异无统计学意义。值得注意的是，CREF组并发症发生率显著更高。经皮穿针固定被证明是治疗I型和III型桡骨远端骨折更有效的方法。与接受外固定治疗的患者相比，接受经皮穿针固定治疗的患者术后并发症更少、疼痛程度更低且日常活动困难更少。
