• 作者：L. Suá ; rez-Arias ; ^{laurasuarezarias@yahoo.es} ; D. Cecilia-Ló ; pez ; I. Espina-Flores ; C. Resines-Erasun
• 关键词：Fractura de radio distal ; Placa volar de soporte ; Fijador externo
• 刊名：Revista Espa帽ola de Cirug铆a Ortop茅dica y Traumatolog铆a
• 出版年：2009
• 期刊代码：pca311_18884415
• 类别：med
• 出版时间：March-April 2009
• 卷：53
• 期：2
• 页码：98-105
• 文件大小：1028 K

Purpose

To compare the functional and radiological results obtained in distal radius intraarticular fractures treated by means of internal fixation with a volar buttress plate vs those treated with an external fixator.

Material and method

We performed a comparative retrospective study of two patient series: 36 distal radius fractures treated with an volar AO T 2.4/2.7 buttress plate and 40 fractures treated with Pennig's dynamic external fixator. We used M眉ller's AO-ASIF classification following the anteroporterior and lateral X-ray study. We collected data about patient characteristics, mechanism of injury and postoperative complications. Minimum follow-up was 10 months. We performed clinical and radiographic evaluations at the beginning, at 3 months anda t the end of follow-up. We used Lidstr枚m's scale for the functional assessment.

Results

In the group treated with a volar buttress plate better radiographic results were obtained. In this group only one case was left with an intraarticular step-off greater than or equal to 3 mm, as compared with 6 cases in the group treated with external fixation. Eighty percent of patients treated with a volar plate obtained excellent or good results on the Lidstr枚m scale, as competed with 72.5%in the external fixation group, there being no statistically significant differences between the two groups. Thirty percent of patients treated with an external fixator developed complications during follow-up, as compared with 22.2%in the volar plate group. OR time in the volar plate group was 74 minutes on average, whereas in the external fixation group it was 42 minutes. Mean time to postoperative mobilization was 12 days in the volar plate group. In patients treated with external fixation, the fixator was dynamized at 40 days on average and withdrawn at 62 days on average.

Conclusions

Our study shows that both kinds of treatment seem to afford similar radiological and functional results. Direct reduction followed by volar buttress plate fixation seems to provide for a more stable sort of anatomical reduction. Nevertheless, such difference does not lead to better functional outcomes. Both methods of treatment present with an acceptable postoperative complications rate.