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Abstract：
Despite recent advances in the surgical management of distal radius fractures (DRFs), the optimal treatment remains controversial as different fixation methods often have similar clinical functional and radiographic outcomes. The objective of this study was to assess the differences in outcomes 1 year postoperatively between volar plating and combined plating for DRFs. In a retrospective cohort study, we evaluated 105 consecutive patients operated with either a volar locking plate or combined dorsal and volar plating. The primary outcome was wrist range of motion (ROM). Secondary outcome measures included hand grip strength, visual analog scale (VAS) pain scores, radiographic examination and patient-related outcome measures. Patients treated with combined plating had significantly inferior wrist flexion, extension and ulnar deviation. The radiographic Batra score 1 year postoperatively was similar for both groups. The PRWE (patient-rated wrist evaluation) score was 16 for the volar plating group and 14 for the combined plating group. The QuickDASH (Quick disabilities of the arm, shoulder and hand) score was 9 for the volar plating group and 16 for the combined plating group. VAS pain scores were 0 at rest and 2 during activity for both groups. Grip strength was similar between the two groups. Hardware removal was done in 18/78 patients for the combined plating group and 1/27 for the volar plate group. Two patients operated with combined plating had tendon ruptures. Our findings indicate that both methods can yield satisfactory clinical and radiographic outcomes. However, combined plating resulted in inferior wrist ROM and substantially higher frequency of hardware removal. The potential advantages of combined plating in stabilizing a comminuted DRF must be balanced by the potential drawbacks such as inferior wrist ROM and higher frequency of hardware removal.
摘要：
尽管桡骨远端骨折（DRF）的手术治疗取得了最新进展，最佳治疗仍存在争议,因为不同的固定方法通常具有相似的临床功能和影像学结局.本研究的目的是评估术后1年掌侧钢板和联合钢板治疗DRF的结果差异。在一项回顾性队列研究中，我们评估了105例接受掌侧锁定钢板或背侧和掌侧钢板联合手术的连续患者。主要结果是腕关节活动范围（ROM）。次要结果测量包括手握力，视觉模拟量表（VAS）疼痛评分，射线照相检查和与患者相关的结果测量。联合钢板治疗的患者腕关节下屈明显，延伸和尺骨偏差。两组术后1年的放射学Batra评分相似。掌侧电镀组的PRWE（患者评估的腕关节评估）评分为16，联合电镀组为14。QuickDASH（手臂的快速残疾，肩和手）掌侧电镀组为9，联合电镀组为16。两组患者静息时VAS疼痛评分均为0，活动时VAS疼痛评分均为2。两组的握力相似。联合钢板组18/78例患者进行硬件去除，掌侧钢板组1/27例。两名接受联合钢板治疗的患者肌腱断裂。我们的发现表明，这两种方法都可以产生令人满意的临床和影像学结果。然而,联合电镀导致腕部ROM较差，硬件移除频率大大提高。组合电镀在稳定粉碎的DRF方面的潜在优势必须通过潜在的缺点来平衡，例如下腕ROM和更高频率的硬件移除。
