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首页> 外文期刊>Injury >The efficacy of closed reduction in displaced distal radius fractures.
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The efficacy of closed reduction in displaced distal radius fractures.

机译：闭合复位移位的distal骨远端骨折的疗效。

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INTRODUCTION: Closed reduction (CR) to restore fracture alignment and subsequent cast fixation is a common practice in the treatment of distal radius fractures. No clear consensus exists about the appropriate indication for CR. This study aims to compare radiological and functional results in patients with moderately to severely displaced distal radius fractures that were immobilised by cast fixation with or without prior CR. PATIENTS AND METHODS: A total of 206 patients with distal radius fractures from one UK hospital were prospectively documented between 2001 and 2002. Patients with moderately to severely displaced fractures that were treated conservatively with or without CR were eligible for this analysis. Fracture displacement was assessed by measurements on injury radiographs and latent class analysis. The radiological and functional results as assessed by range of motion; and the Disabilities of the Arm, Shoulder and Hand (DASH); Gartland and Werley; and SF-36 scores were compared after 6 weeks, 6 months and 1 year. RESULTS: As many as 83 patients (seven males) with a mean age of 62.2 years were included; 62 patients were treated with CR, the remaining 21 did not receive CR. During the follow-up period, no differences were found in the measurements of range of motion, DASH and SF-36 scores between the treatment groups. Fractures that were treated with CR lost anatomical restoration. However, after 1 year, palmar tilt and radial angles had significantly improved compared with the baseline measurements. Although no significant difference of radiological parameters between the treatment groups was found, the Gartland and Werley score resulted in a significantly better outcome for those patients without CR after 1 year. CONCLUSIONS: Although all patients - independent of their treatment - reached a successful level of activities in their daily life, there was no benefit of CR for patients with moderately to severely displaced fractures. The decision to treat with CR should be made carefully, especially in patients with high wrist-function demands.
机译：简介：闭合复位（CR）以恢复骨折对准并随后进行石膏固定是radius骨远端骨折的常见治疗方法。对于适当的CR适应症尚无明确共识。这项研究的目的是比较中度至重度移位的distal骨远端骨折患者的放射学和功能结果，这些患者通过有或没有CR的石膏固定固定。患者与方法：2001年至2002年间，一间英国医院总共对206例radius骨远端骨折患者进行了前瞻性记录。接受或不采用CR保守治疗的中度至重度骨折患者均符合此项分析的条件。通过在损伤射线照相上的测量和潜在类别分析来评估骨折移位。通过运动范围评估的放射学和功能结果;以及手臂，肩膀和手部的残疾（DASH）;加特兰和韦利;在6周，6个月和1年后比较SF-36得分。结果：平均年龄为62.2岁的83例患者（七名男性）被纳入研究。 62例接受CR治疗的患者，其余21例未接受CR。在随访期间，各治疗组之间的运动范围，DASH和SF-36得分的测量均无差异。用CR治疗的骨折失去了解剖修复。但是，一年后，与基线测量值相比，手掌倾斜度和径向角明显改善。尽管未发现治疗组之间的放射学参数有显着差异，但对于1年后无CR的患者，Gartland和Werley评分可显着改善结局。结论：尽管所有患者（独立于治疗）均已成功达到日常生活活动水平，但对于中度至重度移位的骨折患者，CR并无益处。应该谨慎地决定使用CR的治疗方法，尤其是对腕功能要求高的患者。

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