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Açık Redüksiyona Uygun Olmayan Radius Distali Metafiz Kırıklarında Eksternal Fiksasyon ile Alçı Döküm Sonuçlarının Karşılaştırılması

Yıl 2021, Cilt 23, Sayı 2, 270 - 278, 31.08.2021
https://doi.org/10.24938/kutfd.895219

Öz

Amaç: Kapalı redüksiyon ve alçı (KRA) ve köprü eksternal fiksasyon (EF) ile tedavi edilen distal radius eklem dışı metafizer kırıklarının radyografik ve fonksiyonel sonuçlarını karşılaştırmayı amaçladık.
Gereç ve Yöntemler: Bu retrospektif çalışmaya distal radius kırığı olan 65 hasta dahil edildi. Hastaların ortalama yaşı 55 idi. Hastalar KRA grubu ve köprü EF grubu olarak adlandırılan iki gruba ayrıldı. Tüm kırıklar AO/OTA tip A3 idi. Tüm hastalar, birinci yılın sonunda Cooney tarafından modifiye edilen Green ve O'Brien Skoru, Mayo Bilek Skoru ve Kol, Omuz ve El Engellilikleri (DASH) ile değerlendirildi.
Bulgular: Ortalama yaş KRA grubunda 54.32±8.61 yıl, köprü EF grubunda 56.65±8.31 yıl idi. Ortalama takip süresi KRA grubunda 24.06±8.67 ay, köprü EF grubunda 24.88±9.2 aydı. Birinci yılın sonunda yapılan değerlendirmede kırıklar radyolojik olarak karşılaştırıldığında, köprü oluşturan EF grubunda radyal eğim ve radyal uzunluk sonuçları KRA grubuna göre istatistiksel olarak anlamlı bulundu. Klinik muayene sırasında kırıkların hareket aralığı karşılaştırıldığında, köprü EF grubunda KRA grubuna göre istatistiksel olarak anlamlı bulundu. Green ve Mayo skorlarında gruplar arası skorlama açısından istatistiksel olarak anlamlı bulunmadı. DASH skoru KRA grubunda 10.88±2.99, köprü EF grubunda 5.73±2.57 idi ve istatistiksel olarak anlamlıydı (p<0.001).
Sonuç: Daha az invaziv bir teknik olması ve başarılı klinik sonuçlar sağlaması nedeniyle yumuşak dokusu açık cerrahiye izin vermeyen AO/OTA tip A3 radius kırıklarında birincil tedavi seçeneklerinden biri olarak köprüleyici EF tedavisi önerilebilir.

Kaynakça

  • 1. Talmaç MA, Görgel MA, Kanar M, Tok O, Özdemir HM. Comparison of three surgical methods in the treatment of intraarticular comminuted distal radius fractures: Volar locking plate, non-bridging external fixator, and bridging external fixator. Eklem Hast ve Cerrahisi. 2019;30(3):224-32.
  • 2. Turan S, Çankaya D, Yinolmaz S, Karakuş D, Dündar A, Özdemir G. Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hast ve Cerrahisi. 2016;27(2):87-93.
  • 3. Ju JH, Jin GZ, Li GX, Hu HY, Hou RX. Comparison of treatment outcomes between nonsurgical and surgical treatment of distal radius fracture in elderly: a systematic review and meta-analysis. Langenbeck’s Arch Surg. 2015;400(7):767-79.
  • 4. Schneppendahl J, Windolf J, Kaufmann RA. Distal radius fractures: Current concepts. J Hand Surg Am. 2012;37(8):1718-25.
  • 5. Abe Y, Doi K, Kuwata N, Yamamoto H, Sunago K, Kawai S. Surgical options for distal radial fractures: Indications and limitations. Arch Orthop Trauma Surg. 1998;117(4–5):188-92.
  • 6. Rodríguez-Merchán EC. Management of comminuted fractures of the distal radius in the adult: Conservative or surgical? Clin Orthop Relat Res. 1998;(353):53-62.
  • 7. Cherubino P, Bini A, Marcolli D. Management of distal radius fractures: Treatment protocol and functional results. Injury. 2010;41(11):1120–6.
  • 8. Rhee PC, Medoff RJ, Shin AY. Complex distal radius fractures: An anatomic algorithm for surgical management. J Am Acad Orthop Surg. 2017;25(2):77-88.
  • 9. Seitz WH, Froimson AI, Leb R, Shapiro JD. Augmented external fixation of unstable distal radius fractures. J Hand Surg Am. 1991;16(6):1010-6.
  • 10. Gausepohl T, Pennig D, Mader K. Principles of external fixation and supplementary techniques in distal radius fractures. Injury. 2000;31(Suppl.1):56-70.
  • 11. Aktekin CN, Altay M, Gursoy Z, Aktekin LA, Ozturk AM, Tabak AY. Comparison between external fixation and cast treatment in the management of distal radius fractures in patients aged 65 years and older. J Hand Surg Am. 2010;35(5):736-42.
  • 12. Egol KA, Walsh M, Romo-Cardoso S, Dorsky S, Paksima N. Distal radial fractures in the elderly: operative compared with nonoperative treatment J Bone Joint Surg Am. 2010;92(9):1851-7.
  • 13. Howard PW, Stewart HD, Hind RE, Burke FD. External fixation or plaster for severely displaced comminuted Colles’ fractures? A prospective study of anatomical and functional results. J Bone Jt Surg - Ser B. 1989;71(1):68-73.
  • 14. Moroni A, Vannini F, Faldini C, Pegreffi F, Giannini S. Cast vs external fixation: A comparative study in elderly osteoporotic distal radial fracture patients. Scand J Surg. 2004;93(1):64-7.
  • 15. Dario P, Matteo G, Carolina C, Marco G, Cristina D, Daniele F et al. Is it necessary to restore radial anatomic parameters after distal radius fractures? Injury. 2014;45(S6):S21–6.
  • 16. Kwok IHY, Leung F, Yuen G. Assessing results after distal radius fracture treatment: a comparison of objective and subjective tools. Geriatr Orthop Surg Rehabil. 2011;2(4):155–60.
  • 17. Souer JS, Lozano-Calderon SA, Ring D. Predictors of wrist function and health status after operative treatment of fractures of the distal radius. J Hand Surg Am. 2008;33(2):157.e1-157.e8.
  • 18. Kreder HJ, Agel J, McKee MD, Schemitsch EH, Stephen D, Hanel DP. a randomized, controlled trial of distal radius fractures with metaphyseal displacement but without joint incongruity: closed reduction and casting versus closed reduction, spanning external fixation, and optional percutaneous K-wires. J Orthop Trauma. 2006;20(2):115–21.
  • 19. Pattee GA, Thompson GH. Anterior and posterior marginal fracture-dislocations of the distal radius. An analysis of the results of treatment. Clin Orthop Relat Res. 1988;(231):183-95.
  • 20. McQueen MM, MacLaren A, Chalmers J. The value of remanipulating Colles’ fractures. J Bone Jt Surg - Ser B. 1986;68(2):232-3.

COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION

Yıl 2021, Cilt 23, Sayı 2, 270 - 278, 31.08.2021
https://doi.org/10.24938/kutfd.895219

Öz

Objective: We aimed to compare the radiographic and functional results of extra-articular metaphyseal fractures of the distal radius treated with closed reduction and plaster casting (CRPC) and bridging external fixation (EF).
Material and Methods: This retrospective study included 65 patients with distal radius fractures. The mean age of the patients was 55 years. Patients were divided into two groups, which were called the CRPC group and bridging EF group. All fractures were AO/OTA type A3. All patients were evaluated with Green and O'Brien Score modified by Cooney, Mayo Wrist Score and The Disabilities of the Arm, Shoulder, and Hand (DASH) at the end of the first year.
Results: The mean age was 54.32±8.61 years in the CRPC group and 56.65±8.31 years in the Bridging EF group. The mean follow-up time was 24.06±8.67 months in the CRPC group and 24.88±9.2 months in the bridging EF group. When the fractures were compared radiologically during the evaluation at the end of the first year, radial inclination and radial length results in the bridging EF group were statistically significant compared to the CRPC group. When the range of motions was compared in the fractures during the clinical examination, they were statistically significant in the bridging EF group compared to the CRPC group. There was no statistical significance in Green and Mayo scores in terms of the scoring between the groups. DASH score was 10.88±2.99 in the CRPC group and 5.73±2.57 in the bridging EF group, and it was statistically significant (p<0.001).
Conclusion: Bridging EF treatment can be recommended as one of the primary treatment options in AO/OTA type A3 radius fractures, whose soft tissue does not allow open surgery, because it is a less invasive technique and provides successful clinical results.

Kaynakça

  • 1. Talmaç MA, Görgel MA, Kanar M, Tok O, Özdemir HM. Comparison of three surgical methods in the treatment of intraarticular comminuted distal radius fractures: Volar locking plate, non-bridging external fixator, and bridging external fixator. Eklem Hast ve Cerrahisi. 2019;30(3):224-32.
  • 2. Turan S, Çankaya D, Yinolmaz S, Karakuş D, Dündar A, Özdemir G. Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hast ve Cerrahisi. 2016;27(2):87-93.
  • 3. Ju JH, Jin GZ, Li GX, Hu HY, Hou RX. Comparison of treatment outcomes between nonsurgical and surgical treatment of distal radius fracture in elderly: a systematic review and meta-analysis. Langenbeck’s Arch Surg. 2015;400(7):767-79.
  • 4. Schneppendahl J, Windolf J, Kaufmann RA. Distal radius fractures: Current concepts. J Hand Surg Am. 2012;37(8):1718-25.
  • 5. Abe Y, Doi K, Kuwata N, Yamamoto H, Sunago K, Kawai S. Surgical options for distal radial fractures: Indications and limitations. Arch Orthop Trauma Surg. 1998;117(4–5):188-92.
  • 6. Rodríguez-Merchán EC. Management of comminuted fractures of the distal radius in the adult: Conservative or surgical? Clin Orthop Relat Res. 1998;(353):53-62.
  • 7. Cherubino P, Bini A, Marcolli D. Management of distal radius fractures: Treatment protocol and functional results. Injury. 2010;41(11):1120–6.
  • 8. Rhee PC, Medoff RJ, Shin AY. Complex distal radius fractures: An anatomic algorithm for surgical management. J Am Acad Orthop Surg. 2017;25(2):77-88.
  • 9. Seitz WH, Froimson AI, Leb R, Shapiro JD. Augmented external fixation of unstable distal radius fractures. J Hand Surg Am. 1991;16(6):1010-6.
  • 10. Gausepohl T, Pennig D, Mader K. Principles of external fixation and supplementary techniques in distal radius fractures. Injury. 2000;31(Suppl.1):56-70.
  • 11. Aktekin CN, Altay M, Gursoy Z, Aktekin LA, Ozturk AM, Tabak AY. Comparison between external fixation and cast treatment in the management of distal radius fractures in patients aged 65 years and older. J Hand Surg Am. 2010;35(5):736-42.
  • 12. Egol KA, Walsh M, Romo-Cardoso S, Dorsky S, Paksima N. Distal radial fractures in the elderly: operative compared with nonoperative treatment J Bone Joint Surg Am. 2010;92(9):1851-7.
  • 13. Howard PW, Stewart HD, Hind RE, Burke FD. External fixation or plaster for severely displaced comminuted Colles’ fractures? A prospective study of anatomical and functional results. J Bone Jt Surg - Ser B. 1989;71(1):68-73.
  • 14. Moroni A, Vannini F, Faldini C, Pegreffi F, Giannini S. Cast vs external fixation: A comparative study in elderly osteoporotic distal radial fracture patients. Scand J Surg. 2004;93(1):64-7.
  • 15. Dario P, Matteo G, Carolina C, Marco G, Cristina D, Daniele F et al. Is it necessary to restore radial anatomic parameters after distal radius fractures? Injury. 2014;45(S6):S21–6.
  • 16. Kwok IHY, Leung F, Yuen G. Assessing results after distal radius fracture treatment: a comparison of objective and subjective tools. Geriatr Orthop Surg Rehabil. 2011;2(4):155–60.
  • 17. Souer JS, Lozano-Calderon SA, Ring D. Predictors of wrist function and health status after operative treatment of fractures of the distal radius. J Hand Surg Am. 2008;33(2):157.e1-157.e8.
  • 18. Kreder HJ, Agel J, McKee MD, Schemitsch EH, Stephen D, Hanel DP. a randomized, controlled trial of distal radius fractures with metaphyseal displacement but without joint incongruity: closed reduction and casting versus closed reduction, spanning external fixation, and optional percutaneous K-wires. J Orthop Trauma. 2006;20(2):115–21.
  • 19. Pattee GA, Thompson GH. Anterior and posterior marginal fracture-dislocations of the distal radius. An analysis of the results of treatment. Clin Orthop Relat Res. 1988;(231):183-95.
  • 20. McQueen MM, MacLaren A, Chalmers J. The value of remanipulating Colles’ fractures. J Bone Jt Surg - Ser B. 1986;68(2):232-3.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Yayınlanma Tarihi 2021/Yaz
Bölüm Makaleler
Yazarlar

Kerim ÖNER
Karadeniz Teknik Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji AD
0000-0001-8415-1057
Türkiye


Muhammet Salih AYAS (Sorumlu Yazar)
REPUBLIC OF TURKEY MINISTRY OF HEALTH ERZURUM REGIONAL EDUCATION AND RESEARCH HOSPITAL
0000-0002-7427-2223
Türkiye

Yayımlanma Tarihi 31 Ağustos 2021
Başvuru Tarihi 11 Mart 2021
Kabul Tarihi 9 Mayıs 2021
Yayınlandığı Sayı Yıl 2021, Cilt 23, Sayı 2

Kaynak Göster

Bibtex @araştırma makalesi { kutfd895219, journal = {Kırıkkale Üniversitesi Tıp Fakültesi Dergisi}, issn = {}, eissn = {2148-9645}, address = {}, publisher = {Kırıkkale Üniversitesi}, year = {2021}, volume = {23}, pages = {270 - 278}, doi = {10.24938/kutfd.895219}, title = {COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION}, key = {cite}, author = {Öner, Kerim and Ayas, Muhammet Salih} }
APA Öner, K. & Ayas, M. S. (2021). COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION . Kırıkkale Üniversitesi Tıp Fakültesi Dergisi , 23 (2) , 270-278 . DOI: 10.24938/kutfd.895219
MLA Öner, K. , Ayas, M. S. "COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION" . Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 23 (2021 ): 270-278 <https://dergipark.org.tr/tr/pub/kutfd/issue/64597/895219>
Chicago Öner, K. , Ayas, M. S. "COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 23 (2021 ): 270-278
RIS TY - JOUR T1 - COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION AU - Kerim Öner , Muhammet Salih Ayas Y1 - 2021 PY - 2021 N1 - doi: 10.24938/kutfd.895219 DO - 10.24938/kutfd.895219 T2 - Kırıkkale Üniversitesi Tıp Fakültesi Dergisi JF - Journal JO - JOR SP - 270 EP - 278 VL - 23 IS - 2 SN - -2148-9645 M3 - doi: 10.24938/kutfd.895219 UR - https://doi.org/10.24938/kutfd.895219 Y2 - 2021 ER -
EndNote %0 Kırıkkale Üniversitesi Tıp Fakültesi Dergisi COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION %A Kerim Öner , Muhammet Salih Ayas %T COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION %D 2021 %J Kırıkkale Üniversitesi Tıp Fakültesi Dergisi %P -2148-9645 %V 23 %N 2 %R doi: 10.24938/kutfd.895219 %U 10.24938/kutfd.895219
ISNAD Öner, Kerim , Ayas, Muhammet Salih . "COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 23 / 2 (Ağustos 2021): 270-278 . https://doi.org/10.24938/kutfd.895219
AMA Öner K. , Ayas M. S. COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION. Kırıkkale Üni Tıp Derg. 2021; 23(2): 270-278.
Vancouver Öner K. , Ayas M. S. COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2021; 23(2): 270-278.
IEEE K. Öner ve M. S. Ayas , "COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION", Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, c. 23, sayı. 2, ss. 270-278, Ağu. 2021, doi:10.24938/kutfd.895219

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