Objective：The rapid expansion of knowledge regarding the functional anatomy of hand and wrist,increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restorat...Objective：The rapid expansion of knowledge regarding the functional anatomy of hand and wrist,increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restoration of distal radius fractures has generated a renewed interest in addressing these fractures in a more precise manner.The purpose of our study was to evaluate the difference in patients function among those treated by 1） closed reduction and Plaster of Paris cast,2） distractor application,or 3） open reduction and internal fixation with a volar plate,and to assess the treatment choice for each particular fracture type.Methods：A prospective study was carried out on 60 patients with fractures of the distal end radius.Fractures were classified according to the AO classification into type A （extra-articular）,type B （partial articular） and type C （complete articular）.After initial evaluation patients were taken up for either conservative or operative treatment and were followed up for two years.Results：Anatomical results were evaluated according to the Sarmiento＇s modification of Lindstrom Criteria,which showed that excellent results were more frequent with open reduction and internal fixation using the plating technique.Clinical and functional results were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification,which was revealed to relate with the type of treatment techniques.Conclusion：There is no customized solution for all the fractures of the distal radius.The choice of treatment should be based on the fracture type,the patient＇s characteristics,the patient＇s demands and the treating surgeon＇s experience and preference.展开更多
Purpose:The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones(RJ)bandage.The objective was to compare this treatment modality with the cast regarding the frequency of...Purpose:The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones(RJ)bandage.The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence,child comfortability,and family satisfaction.Methods:The study was a randomized controlled non-inferiority clinical trial including children with recent(less than 5 days)fractures at the distal end of the radius OTA/AO 23-A2,which is usually treated conservatively.Those with open fractures,pathological fracture,severely displaced fracture that needs reduction or multiple injuries were excluded.The participants were divided randomly into 2 groups according to the treatment modalities.Group 1 was treated by plaster of Paris cast(the control group).and Group 2 by modified RJ bandage(the trial group).The difference between the 2 groups was found by the Chi-squared test.The difference was considered statistically significant when the p value was less than 0.05.Results:There were 150 children(aged 2-12 years,any gender)included in the study,75 in each group.The complications occured in 5(3.3%)cases only,pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2.There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment(p=0.649).Children treated by RJ bandages were more comfortable than those treated by the cast(97.3%vs.73.3%,p<0.001)with a statistically significant difference between them.Contrary to that,the families were more satisfied with the cast than RJ bandage(88.0%vs.81.3%),but without a statistically significant difference(p=0.257).Conclusion:RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.展开更多
目的:探讨经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折的临床疗效。方法:回顾性分析我院于2014年6月至2017年6月收治的行掌侧入路锁定加压钢板内固定治疗的不稳定右桡骨远端骨折患者53例,观察患者临床疗效、骨折愈合情况、...目的:探讨经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折的临床疗效。方法:回顾性分析我院于2014年6月至2017年6月收治的行掌侧入路锁定加压钢板内固定治疗的不稳定右桡骨远端骨折患者53例,观察患者临床疗效、骨折愈合情况、腕关节恢复情况、术后并发症发生情况。结果:末次随访根据Gartland and Werlkey功能评分发现手术治疗优良率为94.34%;末次随访患者掌倾角、尺偏角、桡骨长度相对术前均有明显改善(P<0.05); 53例患者术后均未见并发症发生;骨折愈合时间为(8.45±1.47)周;至末次随访,腕关节活动度恢复至健侧78%～100%,握力恢复至健侧72%～91%。结论:经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折临床疗效较好,可最大程度恢复桡骨长度、掌倾角、尺偏角,且术后腕关节恢复良好,术后未见并发症发生。展开更多
文摘Objective：The rapid expansion of knowledge regarding the functional anatomy of hand and wrist,increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restoration of distal radius fractures has generated a renewed interest in addressing these fractures in a more precise manner.The purpose of our study was to evaluate the difference in patients function among those treated by 1） closed reduction and Plaster of Paris cast,2） distractor application,or 3） open reduction and internal fixation with a volar plate,and to assess the treatment choice for each particular fracture type.Methods：A prospective study was carried out on 60 patients with fractures of the distal end radius.Fractures were classified according to the AO classification into type A （extra-articular）,type B （partial articular） and type C （complete articular）.After initial evaluation patients were taken up for either conservative or operative treatment and were followed up for two years.Results：Anatomical results were evaluated according to the Sarmiento＇s modification of Lindstrom Criteria,which showed that excellent results were more frequent with open reduction and internal fixation using the plating technique.Clinical and functional results were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification,which was revealed to relate with the type of treatment techniques.Conclusion：There is no customized solution for all the fractures of the distal radius.The choice of treatment should be based on the fracture type,the patient＇s characteristics,the patient＇s demands and the treating surgeon＇s experience and preference.
基金the radiologist(Rahima Salih Nabi,phone:009647504807202)in the imaging department at Duhok Emergency Hospital for kind her help in evaluating the outcome of the cases radiologically.
文摘Purpose:The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones(RJ)bandage.The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence,child comfortability,and family satisfaction.Methods:The study was a randomized controlled non-inferiority clinical trial including children with recent(less than 5 days)fractures at the distal end of the radius OTA/AO 23-A2,which is usually treated conservatively.Those with open fractures,pathological fracture,severely displaced fracture that needs reduction or multiple injuries were excluded.The participants were divided randomly into 2 groups according to the treatment modalities.Group 1 was treated by plaster of Paris cast(the control group).and Group 2 by modified RJ bandage(the trial group).The difference between the 2 groups was found by the Chi-squared test.The difference was considered statistically significant when the p value was less than 0.05.Results:There were 150 children(aged 2-12 years,any gender)included in the study,75 in each group.The complications occured in 5(3.3%)cases only,pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2.There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment(p=0.649).Children treated by RJ bandages were more comfortable than those treated by the cast(97.3%vs.73.3%,p<0.001)with a statistically significant difference between them.Contrary to that,the families were more satisfied with the cast than RJ bandage(88.0%vs.81.3%),but without a statistically significant difference(p=0.257).Conclusion:RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.
文摘目的探讨外固定支架与钢板内固定治疗不稳定型桡骨远端骨折的疗效差异。方法 206例不稳定型桡骨远端骨折患者分为两组,103例进行内固定手术,另外103例采用外固定支架治疗。两组患者术后进行一年半的随访,比较恢复情况。结果按Gartland and Werley评分标准,外固定支架组优良率为84.5%,内固定组优良率为85.4%,两者差异无统计学意义(P>0.05)。针对不同AO分型的骨折,外固定支架与钢板内固定的治疗效果不同。治疗B型骨折钢板内固定的优良率(84.1%)高于外固定支架(66.7%)(P<0.05),治疗C型骨折外固定支架的优良率(88.2%)高于钢板内固定(70.0%)(P<0.05)。结论外固定支架与钢板内固定治疗桡骨远端不稳定型骨折均有较好疗效。治疗方法可根据AO分型的不同进行选择。
文摘目的:探讨经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折的临床疗效。方法:回顾性分析我院于2014年6月至2017年6月收治的行掌侧入路锁定加压钢板内固定治疗的不稳定右桡骨远端骨折患者53例,观察患者临床疗效、骨折愈合情况、腕关节恢复情况、术后并发症发生情况。结果:末次随访根据Gartland and Werlkey功能评分发现手术治疗优良率为94.34%;末次随访患者掌倾角、尺偏角、桡骨长度相对术前均有明显改善(P<0.05); 53例患者术后均未见并发症发生;骨折愈合时间为(8.45±1.47)周;至末次随访,腕关节活动度恢复至健侧78%～100%,握力恢复至健侧72%～91%。结论:经掌侧入路锁定加压钢板内固定治疗不稳定右桡骨远端骨折临床疗效较好,可最大程度恢复桡骨长度、掌倾角、尺偏角,且术后腕关节恢复良好,术后未见并发症发生。
