A comparative study of fragment-specific versus volar plate fixation of distal radius fractures.
A comparative study of fragment-specific versus volar plate fixation of distal radius fractures.
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DOI：
10.1097/prs.0b013e3181891677
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发表时间：
2008-11
影响因子：
3.6
通讯作者：
Chung KC
中科院分区：
文献类型：
--
作者：
Sammer DM;Fuller DS;Kim HM;Chung KC
有许多钢板系统可用于治疗桡骨远端骨折(DRF)，决定使用哪种类型可能很困难。这是一项前瞻性的队列研究，比较了两种常用的固定系统的结果：片段特异性固定(FSF)和固定角度掌侧锁定钢板系统(VLP)。对两组连续的DRF进行了前瞻性评估。第一组接受FSF治疗，第二组接受VLP治疗。分别于术后即刻、术后6个月和12个月收集放射学、功能和患者评分结果(MHQ)。记录并发症，并根据严重程度进行分级。14名接受FSF治疗的DRF和85名接受VLP治疗的DRF入选。在最后的随访中，两组患者的径向倾斜度相似(23°vs.25°)；然而，椎弓根螺钉组的掌侧倾斜度更差(−为10°vs.10°，p<；0.05)。此外，FSF队列中的大多数人表现出相对桡骨长度的损失(63%的队列具有正尺骨方差)。在6个月的VLP队列中，握力、握力、MHQ评分和大多数活动度测量都优于VLP组，尽管不是所有的差异都有统计学意义。到12个月时，功能和患者评分结果的差异较小，这表明随着时间的推移，FSF队列倾向于达到VLP队列的结果。需要再次手术的并发症在FSF队列中较高(p<；0.05)。VLP能在术后早期获得更稳定的固定和更好的客观和主观效果。与FSF相比，需要再次手术的并发症较少。
There are many plating systems available for treating distal radius fractures (DRFs), and the decision of which type to use can be difficult. This is a prospective cohort study that compares outcomes of two commonly used fixation systems: fragment specific fixation (FSF) and a fixed-angle volar locking plate system (VLPS). Two cohorts of consecutive DRFs were prospectively evaluated. The first cohort was treated with FSF and the second with a VLPS. Radiographic, functional, and patient-rated outcomes (MHQ) were collected immediately post-operatively, and at six and twelve months post-operatively. Complications were recorded and graded by severity. Fourteen DRFs treated with FSF and eighty-five DRFs treated with the VLPS were enrolled. At final follow-up, radial inclination was similar in both cohorts (23° vs. 25°); however, volar tilt was worse in the FSF cohort (−10° vs. 10°, p<0.05). Additionally, the majority of the FSF cohort demonstrated a loss of relative radial length (63% of cohort with positive ulnar variance). Grip strength, pinch strength, MHQ scores, and most ROM measurements were superior in the VLPS cohort at 6 months, although not all differences were statistically significant. By 12 months the differences in functional and patient-rated outcomes were smaller, suggesting that the FSF cohort tended to reach the outcomes of the VLPS cohort over time. Complications requiring re-operation were higher in the FSF cohort (p<0.05). The VLPS results in more stable fixation and better objective and subjective outcomes early in the post-operative period. It has fewer complications requiring re-operation than FSF.