PDF(Pubmed)
Abstract：
Background Open reduction and internal fixation of distal radius fractures is one of the most common procedures performed in wrist surgery. The use of volar locking plate has gained increasing interest in the past decade. Epiphyseal fixation can be done either with locking screws or smooth locking pegs, with no evidence supporting the use of one rather than the other. Purpose The aim of this study is to compare the stability of distal radius fixation by volar locking plate using locking screws or smooth locking pegs. Methods Adult patients with A2-A3 AO fractures treated with a volar plate with locking screws only or smooth locking pegs only were retrospectively included. Radiographic assessment was performed to evaluate extra-articular parameters in the intraoperative postreduction and fixation period and after bony healing. Forty-seven distal radius fractures were included. Results Twenty-four fractures had fixation with locking screws and 23 had fixation with smooth locking pegs. For both groups, all radiographic parameters measured showed a statistically significant difference between the intraoperative postreduction and fixation period and the remote postoperative period after union of the fracture ( p < 0.05) attesting a slight loss of reduction. Nevertheless, there were no significant differences between the groups in radiographic extra-articular parameters. Conclusion This clinical study shows that there is no difference in stability fixation between locking screws or smooth locking pegs in A2-A3 distal radius fractures. Clinical Relevance The use of smooth locking pegs only for epiphyseal fixation appears to be safe in volar plating of A2-A3 distal radius fractures in adult patients and could be an alternative to locking screws. More clinical data are needed to confirm these results. Level of Evidence Level III; retrospective comparative study.
摘要：
背景桡骨远端骨折切开复位内固定是腕关节手术中最常见的手术之一。在过去的十年中，掌侧锁定板的使用引起了越来越多的兴趣。骨phy固定可以用锁定螺钉或光滑的锁定钉完成，没有证据支持使用一个而不是另一个。目的本研究的目的是比较使用锁定螺钉或光滑锁定钉通过掌侧锁定板固定桡骨远端的稳定性。方法回顾性分析成人A2-A3AO骨折患者，仅使用掌侧钢板加锁定螺钉或仅使用光滑锁定钉治疗。在术中复位和固定期间以及骨愈合后，进行了影像学评估以评估关节外参数。包括47例桡骨远端骨折。结果24例骨折采用锁定螺钉固定，23例采用光滑锁定钉固定。对于这两个群体来说，所测量的所有影像学参数显示,术中复位固定后与骨折愈合后远端术后有统计学意义的差异(p<0.05),这表明骨折的复位略有减少.然而，两组的影像学关节外参数无显著差异.结论本临床研究表明，在A2-A3桡骨远端骨折中，锁定螺钉或光滑锁定钉的稳定性固定没有差异。临床意义在成人患者的A2-A3桡骨远端骨折的掌侧钢板中，仅将光滑的锁定钉用于骨phy固定似乎是安全的，并且可以替代锁定螺钉。需要更多的临床数据来证实这些结果。证据水平III级；回顾性比较研究。
