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首页> 外文期刊>Injury >Radiological outcomes of distal radius extra-articular fragility fractures treated with extra-focal kirschner wires.
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Radiological outcomes of distal radius extra-articular fragility fractures treated with extra-focal kirschner wires.

机译：extra外克氏针治疗radius骨远端关节外脆性骨折的放射学结果。

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INTRODUCTION: The classical colles fracture (extra-articular, dorsally angulated distal radius fracture) in patients with osteoporotic bone is becoming increasingly more frequent. There still appears to be no clear consensus on the most appropriate surgical management of these injuries. The purpose of this study is to appraise the use of percutaneous extra-focal pinning, in the management of the classical colles fracture. METHODS: We retrospectively analysed 72 consecutive cases of colles fractures treated with inter-fragmentary k-wire fixation, in female patients over 60 years of age, in two orthopaedic centres, under the care of 12 different orthopaedic surgeons. We correlated the radiographical distal radius measurements (ulnar variance, volar tilt, and radial inclination) at the pre-operative and intra-operative stages with the final radiographical outcome. RESULT: Mean dorsal angulation was 21 degrees at time of presentation. Closed reduction significantly improved fracture position to a mean of 2.7 degrees volar angulation (p<0.05). Mean angulation at time of k-wire removal was 1.6 degrees dorsal, this was not significant in comparison to post-reduction measurements (p<0.05). Mean ulnar variance at time of presentation was 2.5mm (range 7.4 to -4.2). Reduction improved fracture displacement to a mean of 0mm, which was statistically significant (p<0.05). Mean ulnar variance at time of k-wire removal was 2.4mm (p<0.05). 56.8% of cases demonstrated radial shortening of 2mm or more. CONCLUSION: In female patients over 60 years of age, the best predictor of radial length, when k-wire fixation is to be used, is the radial length prior to fracture reduction. Thus if there is radial shortening visible in the initial radiographs as measured in terms of ulnar variance, one should consider a method of fixation other than inter-fragmentary k-wires.
机译：简介：骨质疏松骨患者的经典colles骨折（关节外，背侧成角度的distal骨远端骨折）变得越来越频繁。对于这些损伤的最合适的手术治疗，似乎仍未达成共识。这项研究的目的是评估经皮穿刺局外钉扎治疗经典colles骨折的使用。方法：我们回顾性分析了在两个矫形外科医师的照护下，在两个矫形中心内，对年龄超过60岁的女性患者，采用片段间k线固定术治疗的72例colles骨折连续病例。我们将术前和术中阶段的放射照相远侧measurements骨测量值（尺骨方差，掌侧倾角和radial骨倾斜度）与最终放射照相的结果相关联。结果：出现时平均背角为21度。闭合复位可将骨折位置显着改善至平均2.7度掌侧角（p <0.05）。拔除k线时的平均角度为背侧1.6度，与复位后的测量结果相比无统计学意义（p <0.05）。出现时的尺骨平均方差为2.5mm（范围7.4至-4.2）。复位可将骨折移位平均提高至0mm，在统计学上具有统计学意义（p <0.05）。拔除k线时的平均尺骨方差为2.4mm（p <0.05）。 56.8％的患者显示radial骨缩短2mm或更多。结论：对于60岁以上的女性患者，使用k线固定时，,骨长度的最佳预测指标是骨折复位前的length骨长度。因此，如果按照尺骨方差测量，在最初的X线照片中可见放射状的缩短，则应考虑使用一种除节间性k线以外的固定方法。

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