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[Poster融合器联合异种骨移植增强术治疗桡骨远端骨折骨缺损]

[Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures].

作者信息

Gao Yi, Ren Xiaomeng, Zeng Chuyang, Du Longbo, Li Meng, Ma Rui, Zhang Wei

机构信息

Chinese PLA General Hospital Medical School, Beijing, 100853, P. R. China.

Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jun 15;39(6):655-661. doi: 10.7507/1002-1892.202504038.

Abstract

OBJECTIVE

To evaluate the effectiveness of Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures.

METHODS

A retrospective analysis was conducted on 20 patients with bone defects complicating distal radius fractures who met the selection criteria and were treated between June 2022 and June 2024. The cohort comprised 2 males and 18 females, aged 54-87 years (mean, 63.3 years). Etiologies included falls in 17 cases, traffic accidents in 2 cases, and crush injury in 1 case. According to AO classification, there were 5 cases of type A, 8 cases of type B, and 7 cases of type C. The interval from injury to operation ranged from 2 to 10 days (mean, 5.8 days). All patients underwent volar plate fixation augmented with Poster Fusion Cage and demineralized xenogeneic bone matrix grafting. The operation time, intraoperative blood loss, fracture healing time, and postoperative complications were recorded. Radiographic parameters, including radial height, volar tilt, and ulnar deviation, were measured on standardized X-ray films obtained immediately postoperatively and at last follow-up, and whether secondary reduction loss occurred was judged. At last follow-up, wrist range of motion (extension, flexion, radial deviation, ulnar deviation, pronation, and supination) and grip strength (expressed as a percentage of the contralateral side) were measured. Wrist function was assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Patient-Rated Wrist Evaluation (PRWE) score.

RESULTS

The operation time was 70-200 minutes (mean, 116.4 minutes), and the intraoperative blood loss was 10-80 mL (mean, 36.5 mL). All surgical incisions healed by first intention, with no neurovascular complications documented. All patients were followed up 9-12 months (mean, 11.6 months). All fractures healed normally, with a healing time of 8-14 weeks (mean, 9.95 weeks). No significant difference was observed in radial height, volar tilt, or ulnar deviation between immediate postoperatively and last follow-up ( >0.05). All fractures achieved satisfactory reduction, with no secondary loss of reduction or implant failure occurring during follow-up. At last follow-up, the range of motion of the affected wrist joint was 60°-65° (mean, 62.5°) in extension, 67°-75° (mean, 71.1°) in flexion, 18°-23° (mean, 20.4°) in radial deviation, 28°-33° (mean, 30.1°) in ulnar deviation, 69°-80° (mean, 74.7°) in pronation, and 69°-82° (mean, 75.6°) in supination. Grip strength recovered to 75%-85% (mean, 80%) of the contralateral side. Functional scores showed a DASH score of 5-15 (mean, 9.4) and PRWE score of 8.0-12.5 (mean, 10.2).

CONCLUSION

The combination of Poster Fusion Cage and xenogeneic bone graft augmentation provides a safe and effective treatment for bone defects in distal radius fractures.

摘要

目的

评估Poster Fusion Cage联合异种骨移植增强术治疗桡骨远端骨折骨缺损的有效性。

方法

对2022年6月至2024年6月期间符合入选标准并接受治疗的20例合并骨缺损的桡骨远端骨折患者进行回顾性分析。该队列包括2例男性和18例女性,年龄54 - 87岁(平均63.3岁)。病因包括跌倒17例、交通事故2例、挤压伤1例。根据AO分类,A型5例,B型8例,C型7例。受伤至手术的间隔时间为2至10天(平均5.8天)。所有患者均接受了Poster Fusion Cage增强的掌侧钢板固定及脱矿异种骨基质移植。记录手术时间、术中出血量、骨折愈合时间及术后并发症。在术后即刻和末次随访时获得的标准化X线片上测量桡骨高度、掌倾角和尺偏角等影像学参数,并判断是否发生二次复位丢失。在末次随访时,测量患侧腕关节活动度(伸展、屈曲、桡偏、尺偏、旋前和旋后)及握力(以对侧的百分比表示)。采用手臂、肩部和手部功能障碍(DASH)评分及患者自评腕关节评估(PRWE)评分评估腕关节功能。

结果

手术时间为70 - 200分钟(平均116.4分钟),术中出血量为10 - 80毫升(平均36.5毫升)。所有手术切口均一期愈合,未记录到神经血管并发症。所有患者均随访9 - 12个月(平均11.6个月)。所有骨折均正常愈合,愈合时间为8 - 14周(平均9.95周)。术后即刻与末次随访时的桡骨高度、掌倾角或尺偏角差异无统计学意义(>0.05)。所有骨折均获得满意复位,随访期间未发生二次复位丢失或内固定失败。在末次随访时,患侧腕关节伸展活动度为60° - 65°(平均62.5°),屈曲活动度为67° - 75°(平均71.1°),桡偏活动度为18° - 23°(平均20.4°),尺偏活动度为28° - 33°(平均30.1°),旋前活动度为69° - 80°(平均74.7°),旋后活动度为69° - 82°(平均75.6°)。握力恢复至对侧的75% - 85%(平均80%)。功能评分显示DASH评分为5 - 15分(平均9.4分),PRWE评分为8.0 - 12.5分(平均10.2分)。

结论

Poster Fusion Cage联合异种骨移植增强术为桡骨远端骨折骨缺损提供了一种安全有效的治疗方法。

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