Abstract：
UNASSIGNED: Comminuted, markedly displaced distal radius fractures can cause instability requiring advanced stabilization with dorsal bridge plating. However, published complication rates of bridge plating widely vary. We hypothesize that complications of bridge plating of distal radius fractures are more prevalent than published rates.
UNASSIGNED: A retrospective review was performed on all patients at an academic level I trauma center treated with a bridge plate for a distal radius fracture from 2014 to 2022.
UNASSIGNED: Sixty-five wrists were included in the final analysis: average age 53 years, male 51%, average plate retention 4 months, and average follow-up 6 months. Carpal tunnel release (CTR) was performed at time of primary procedure in 7 (10%) cases. Radial height, radial inclination, dorsal tilt, and ulnar variance were all significantly improved (P < .001). Grip strength, flexion, extension, and supination were significantly limited (P < .03). Twenty-one patients (32%) developed 35 major complications requiring unplanned reoperation, including mechanical hardware-related complication (15%), deep infection (11%), nonunion/delayed union (9%), adhesions (6%), median neuropathy (6%), symptomatic arthritis (5%), and tendon rupture (2%). Plate breakage occurred in 3 patients (5%) and was always localized over the central drill holes of the bridge plate.
UNASSIGNED: Major complications for bridge plating of distal radius fractures were higher at our institution than previously published. Plate breakage should prompt reconsideration of plate design to avoid drill holes over the wrist joint. Signs and symptoms of carpal tunnel syndrome should be carefully assessed at initial presentation, and consideration for concomitant CTR should be strongly considered.
UNASSIGNED: A retrospective review was performed on all patients at an academic level I trauma center treated with a bridge plate for a distal radius fracture from 2014 to 2022.
UNASSIGNED: Sixty-five wrists were included in the final analysis: average age 53 years, male 51%, average plate retention 4 months, and average follow-up 6 months. Carpal tunnel release (CTR) was performed at time of primary procedure in 7 (10%) cases. Radial height, radial inclination, dorsal tilt, and ulnar variance were all significantly improved (P < .001). Grip strength, flexion, extension, and supination were significantly limited (P < .03). Twenty-one patients (32%) developed 35 major complications requiring unplanned reoperation, including mechanical hardware-related complication (15%), deep infection (11%), nonunion/delayed union (9%), adhesions (6%), median neuropathy (6%), symptomatic arthritis (5%), and tendon rupture (2%). Plate breakage occurred in 3 patients (5%) and was always localized over the central drill holes of the bridge plate.
UNASSIGNED: Major complications for bridge plating of distal radius fractures were higher at our institution than previously published. Plate breakage should prompt reconsideration of plate design to avoid drill holes over the wrist joint. Signs and symptoms of carpal tunnel syndrome should be carefully assessed at initial presentation, and consideration for concomitant CTR should be strongly considered.
摘要：
■粉碎，显著移位的桡骨远端骨折可引起不稳定,需要用背桥钢板进行深度稳定.然而,已发表的桥镀并发症发生率差异很大。我们假设桡骨远端骨折的桥接板并发症比已发表的发生率更普遍。
■对2014年至2022年在学术一级创伤中心用桥接钢板治疗桡骨远端骨折的所有患者进行了回顾性审查。
■最终分析包括65个手腕：平均年龄53岁，男性51%,平均平板保留4个月，平均随访6个月。7例（10％）患者在初次手术时进行腕管松解术（CTR）。径向高度,径向倾角,背侧倾斜,尺骨方差均显著改善(P<.001)。握力,屈曲，扩展,旋后明显受限（P<.03）。21例患者（32％）出现35种需要非计划再次手术的主要并发症，包括机械硬件相关的并发症(15%)，深部感染（11%），不愈合/延迟愈合（9%），粘连（6%），中位神经病变（6%），症状性关节炎（5%），肌腱断裂(2%)。3例患者（5％）发生了板断裂，并且始终位于桥板的中央钻孔上。
■在我们的机构中，桡骨远端骨折的桥钢板的主要并发症比以前发表的更高。板断裂应提示重新考虑板设计，以避免在腕关节上钻孔。腕管综合征的体征和症状应在初次就诊时仔细评估，应强烈考虑合并CTR。
■对2014年至2022年在学术一级创伤中心用桥接钢板治疗桡骨远端骨折的所有患者进行了回顾性审查。
■最终分析包括65个手腕：平均年龄53岁，男性51%,平均平板保留4个月，平均随访6个月。7例（10％）患者在初次手术时进行腕管松解术（CTR）。径向高度,径向倾角,背侧倾斜,尺骨方差均显著改善(P<.001)。握力,屈曲，扩展,旋后明显受限（P<.03）。21例患者（32％）出现35种需要非计划再次手术的主要并发症，包括机械硬件相关的并发症(15%)，深部感染（11%），不愈合/延迟愈合（9%），粘连（6%），中位神经病变（6%），症状性关节炎（5%），肌腱断裂(2%)。3例患者（5％）发生了板断裂，并且始终位于桥板的中央钻孔上。
■在我们的机构中，桡骨远端骨折的桥钢板的主要并发症比以前发表的更高。板断裂应提示重新考虑板设计，以避免在腕关节上钻孔。腕管综合征的体征和症状应在初次就诊时仔细评估，应强烈考虑合并CTR。
