PDF(Sci-hub)
Abstract：
The comminuted distal radius fractures among elderly people are usually linked to osteoporosis, and repairing them in this context is a therapeutical challenge. Several teams have reported good results of radius resurfacing. The goal of our study was to evaluate the usability of the wrist in a new series of patients after surgery. We performed a monocentric retrospective study on the data of the medical files. All the included patients were older than 65 years and received a wrist hemiarthroplasty according to the criteria that have been established by the in charge medical team. Eleven patients have been included, their average age was 80.4 years old, and the average follow-up was 18.3 months. The average QuickDASH Score was 59 (27-95). The Visual Analogue Scale for pain was in average 3.8/10 and the average mobility was: flexion 36° (12-50), extension 27° (12-50), radial deviation 15° (12-15), ulnar deviation 26° (12-40), pronation-supination range of motion 164° (150-170). The average measured strength was 44% (16-72%) of the strength of the unaffected hand. Our results are rather modest, probably because of insufficient follow-up and very severe fractures. Furthermore, the implant that has been used does not take into account the distal radioulnar joint. Another bound of this treatment is the complexity of surgical revision in case of bad result. So far, hemiarthroplasty cannot be considered as the standard treatment for complex fractures of the distal radius.
摘要：
老年人桡骨远端粉碎性骨折通常与骨质疏松有关,在这种情况下修复它们是一个治疗上的挑战。几个团队报告了半径重铺的良好结果。我们研究的目标是评估手术后新系列患者中手腕的可用性。我们对医疗档案的数据进行了单中心回顾性研究。所有纳入的患者年龄均超过65岁，并根据主管医疗团队制定的标准接受了腕关节置换术。已包括11名患者，他们的平均年龄是80.4岁，平均随访18.3个月。平均QuickDASH评分为59（27-95）。疼痛的视觉模拟评分平均为3.8/10，平均活动度为：屈曲36°（12-50），延伸27°(12-50),径向偏差15°(12-15),尺骨偏差26°(12-40),内旋-外旋运动范围164°（150-170）。平均测量强度为未受影响的手的强度的44%(16-72%)。我们的结果相当温和，可能是因为随访不足和非常严重的骨折。此外，已使用的植入物不考虑远端尺尺关节。这种治疗的另一个限制是在不良结果的情况下进行手术翻修的复杂性。到目前为止,人工股骨头置换术不能被认为是治疗桡骨远端复杂骨折的标准方法。
