Welch Jessica M, Lauck Bradley, Lorenzana Daniel J, Pidgeon Tyler S, Richard Marc J, Klifto Christopher S, Ruch David S
Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
University of North Carolina School of Medicine, Chapel Hill, USA.
Hand (N Y). 2025 Sep 7:15589447251366460. doi: 10.1177/15589447251366460.
Dorsal wrist spanning plate (DWSP) fixation in distal radius fractures (DRFs) has been proposed to allow earlier mobilization in polytraumatized patients by enabling early weightbearing (WB) through the injured wrist. The purpose of this study is to compare radiographic and clinical outcomes in patients who bore weight through the injured wrist within the early postoperative period with patients who did not bear weight.
Patients who underwent DWSP fixation at a single institution were retrospectively identified. Patients who bore weight through the injured wrist for purposes of assisted ambulation (WB) were identified and compared with patients who did not bear weight through the injured wrist (non-weightbearing [NWB]). Outcomes included complication rates, radiographic measurements, visual analogue scale (VAS) pain scores, and range of motion.
In total, 123 patients underwent DWSP fixation for DRF between 2005 and 2018, including 30 in the WB cohort and 93 in the NWB cohort. There was no significant difference in patient age, sex, or injury to dominant extremity. The WB group had longer duration of DWSP before removal (121 ± 26.2 vs 106.3 ± 29.5 days, = .02). There was no significant difference in complication rates (13.3% vs 16.1%, = .71), clinical outcomes (VAS, flexion, extension, pronosupination), or radiographic parameters preoperatively, postoperatively, after plate removal, or at final follow-up.
Early WB through the injured wrist appears to be safe in patients with DRFs treated with DWSP. There were no significant differences in outcomes or complications between patients treated with DWSP based on WB status postoperatively.
Retrospective cohort, Level III.
对于桡骨远端骨折（DRF），有人提出采用腕背跨关节钢板（DWSP）固定，以使多发伤患者能够通过受伤的手腕早期负重（WB），从而更早地进行活动。本研究的目的是比较术后早期通过受伤手腕负重的患者与未负重患者的影像学和临床结果。
回顾性确定在单一机构接受DWSP固定的患者。确定通过受伤手腕负重以辅助行走的患者（WB），并与未通过受伤手腕负重的患者（非负重[NWB]）进行比较。结果包括并发症发生率、影像学测量、视觉模拟量表（VAS）疼痛评分和活动范围。
2005年至2018年间，共有123例患者因DRF接受了DWSP固定，其中WB队列30例，NWB队列93例。患者年龄、性别或优势肢体损伤方面无显著差异。WB组在取出DWSP前的时间更长（121±26.2天对106.3±29.5天，P = .02）。并发症发生率（13.3%对16.1%，P = .71）、临床结果（VAS、屈曲、伸展、旋前旋后）或术前、术后、取出钢板后或最终随访时的影像学参数均无显著差异。
对于接受DWSP治疗的DRF患者，早期通过受伤手腕负重似乎是安全的。根据术后WB状态接受DWSP治疗的患者在结果或并发症方面无显著差异。
回顾性队列研究，III级。
