Comparative Analysis of Radial Corrective Osteotomy and Sauvé–Kapandji Procedure for Malunited Distal Radius Fractures in Older Adults

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2024-11-01 DOI:10.1016/j.jhsa.2024.06.007

Lei Wang MD , Ziyang Huang MD , Wei Xie MD , Deqing Luo MD , Hui Liu MD, PhD , Kejian Lian MD , Dasheng Lin MD, PhD

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引用次数: 0

Abstract

Purpose

Malunited distal radius fractures frequently occur in the older population, posing a dilemma in selecting ideal management for symptomatic patients. Radial corrective osteotomy (RCO) and the Sauvé–Kapandji procedure (SK) have been used to treat this challenging condition. However, it remains unknown which approach is better for the older population. The objective of this study was to compare the outcomes of RCO with those of SK for the treatment of symptomatic distal radius malunion in older adults.

Methods

Thirty-three patients aged ≥60 years, with malunited distal radius fractures, were randomized to be treated with either RCO or SK and followed for a minimum of 2 years. The primary evaluation parameter was grip strength, and secondary outcome parameters were surgical time, range of motion of the wrist, exercise-related wrist pain assessment using visual analog scale scores, radiographic results, patient-reported outcomes evaluated using the Disability of the Arm, Shoulder, and Hand (DASH), and Patient-Related Wrist Evaluation (PRWE) scores.

Results

The average follow-up duration was 36.7 ± 10.2 months. The grip strength was significantly higher in the RCO group. The surgical time was shorter in the SK group than in the RCO group. The postoperative wrist range of motion and visual analog scale scores for exercise-related pain alleviation were similar in both groups. The ulnar variance decreased in both groups and was similar when compared with the postoperative images. The DASH and PRWE scores were similar between the RCO and SK groups.

Conclusions

Radial corrective osteotomy and SK surgeries have similar clinical and functional outcomes in patients aged ≥60 years. Grip strength is higher in the RCO group than in the SK group. However, the operating time to accomplish SK is shorter than RCO.

Type of study/level of evidence

Therapeutic II.

查看原文本刊更多论文

桡骨矫正截骨术与 Sauvé-Kapandji 手术治疗老年人桡骨远端钝性骨折的比较分析。

目的：桡骨远端畸形骨折经常发生在老年人群中，这给有症状的患者选择理想的治疗方法带来了难题。桡骨矫正截骨术（RCO）和Sauvé-Kapandji手术（SK）已被用于治疗这种具有挑战性的病症。然而，哪种方法更适合老年人群仍是个未知数。本研究旨在比较RCO和SK治疗老年人症状性桡骨远端骨不连的效果：33名年龄≥60岁、桡骨远端骨折错合的患者被随机分配接受RCO或SK治疗，并接受至少2年的随访。主要评估参数为握力，次要结果参数为手术时间、腕关节活动范围、使用视觉模拟量表评分进行的运动相关腕痛评估、放射学结果、使用手臂、肩部和手部残疾（DASH）评估的患者报告结果以及患者相关腕关节评估（PRWE）评分：平均随访时间为（36.7 ± 10.2）个月。RCO 组的握力明显更高。SK组的手术时间短于RCO组。两组的术后腕关节活动范围和运动相关疼痛缓解视觉模拟量表评分相似。两组的尺侧方差均有所减少，与术后图像相比也相似。RCO组和SK组的DASH和PRWE评分相似：结论：对于年龄≥60岁的患者，桡骨矫正截骨术和SK手术具有相似的临床和功能效果。RCO组的握力高于SK组。不过，完成 SK 的手术时间比 RCO 短：研究类型/证据级别：治疗 II。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.