[Poster融合器联合异种骨移植物增强术治疗桡骨远端骨折骨缺损]。

Q3 Medicine
Yi Gao, Xiaomeng Ren, Chuyang Zeng, Longbo Du, Meng Li, Rui Ma, Wei Zhang
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引用次数: 0

摘要

目的:评价Poster融合器联合异种骨增强术治疗桡骨远端骨折骨缺损的疗效。方法:回顾性分析2022年6月至2024年6月期间符合入选标准的桡骨远端骨折合并骨缺损患者20例。男性2名,女性18名,年龄54-87岁(平均63.3岁)。病因包括跌倒17例,交通事故2例,挤压伤1例。根据AO分型,A型5例,B型8例,c型7例。伤至手术间隔2 ~ 10天,平均5.8天。所有患者均行掌侧钢板固定,外加Poster融合器和脱矿异种骨基质移植。记录手术时间、术中出血量、骨折愈合时间及术后并发症。在术后立即及最后随访的标准化x线片上测量放射学参数,包括桡骨高度、掌侧倾斜和尺侧偏差,并判断是否发生二次复位损失。最后随访时,测量腕关节活动范围(伸、屈、桡侧偏差、尺侧偏差、旋前和旋后)和握力(以对侧百分比表示)。腕功能采用手臂、肩和手的残疾(DASH)评分和患者评定腕功能评估(PRWE)评分进行评估。结果:手术时间70 ~ 200 min(平均116.4 min),术中出血量10 ~ 80 mL(平均36.5 mL)。所有手术切口一次愈合,无神经血管并发症记录。所有患者随访9 ~ 12个月(平均11.6个月)。骨折愈合正常,愈合时间8 ~ 14周,平均9.95周。术后即刻与末次随访桡骨高度、掌侧倾角、尺侧偏差均无显著差异(P < 0.05)。所有骨折均获得满意的复位,随访期间未发生二次复位丢失或植入物失败。最后随访时,受影响的腕关节活动范围为伸60°-65°(平均62.5°),屈67°-75°(平均71.1°),桡偏18°-23°(平均20.4°),尺偏28°-33°(平均30.1°),旋前69°-80°(平均74.7°),旋后69°-82°(平均75.6°)。对侧握力恢复到75%-85%(平均80%)。功能评分:DASH评分5-15分(平均9.4分),PRWE评分8.0-12.5分(平均10.2分)。结论:Poster融合器联合异种骨增强是治疗桡骨远端骨折骨缺损安全有效的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures].

Objective: To evaluate the effectiveness of Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures.

Methods: A retrospective analysis was conducted on 20 patients with bone defects complicating distal radius fractures who met the selection criteria and were treated between June 2022 and June 2024. The cohort comprised 2 males and 18 females, aged 54-87 years (mean, 63.3 years). Etiologies included falls in 17 cases, traffic accidents in 2 cases, and crush injury in 1 case. According to AO classification, there were 5 cases of type A, 8 cases of type B, and 7 cases of type C. The interval from injury to operation ranged from 2 to 10 days (mean, 5.8 days). All patients underwent volar plate fixation augmented with Poster Fusion Cage and demineralized xenogeneic bone matrix grafting. The operation time, intraoperative blood loss, fracture healing time, and postoperative complications were recorded. Radiographic parameters, including radial height, volar tilt, and ulnar deviation, were measured on standardized X-ray films obtained immediately postoperatively and at last follow-up, and whether secondary reduction loss occurred was judged. At last follow-up, wrist range of motion (extension, flexion, radial deviation, ulnar deviation, pronation, and supination) and grip strength (expressed as a percentage of the contralateral side) were measured. Wrist function was assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Patient-Rated Wrist Evaluation (PRWE) score.

Results: The operation time was 70-200 minutes (mean, 116.4 minutes), and the intraoperative blood loss was 10-80 mL (mean, 36.5 mL). All surgical incisions healed by first intention, with no neurovascular complications documented. All patients were followed up 9-12 months (mean, 11.6 months). All fractures healed normally, with a healing time of 8-14 weeks (mean, 9.95 weeks). No significant difference was observed in radial height, volar tilt, or ulnar deviation between immediate postoperatively and last follow-up ( P>0.05). All fractures achieved satisfactory reduction, with no secondary loss of reduction or implant failure occurring during follow-up. At last follow-up, the range of motion of the affected wrist joint was 60°-65° (mean, 62.5°) in extension, 67°-75° (mean, 71.1°) in flexion, 18°-23° (mean, 20.4°) in radial deviation, 28°-33° (mean, 30.1°) in ulnar deviation, 69°-80° (mean, 74.7°) in pronation, and 69°-82° (mean, 75.6°) in supination. Grip strength recovered to 75%-85% (mean, 80%) of the contralateral side. Functional scores showed a DASH score of 5-15 (mean, 9.4) and PRWE score of 8.0-12.5 (mean, 10.2).

Conclusion: The combination of Poster Fusion Cage and xenogeneic bone graft augmentation provides a safe and effective treatment for bone defects in distal radius fractures.

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中国修复重建外科杂志
中国修复重建外科杂志 Medicine-Medicine (all)
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