早期拔除背侧跨越钢板辅助桡骨远端固定：安全性和有效性

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-09-16 DOI:10.1016/j.jhsg.2025.100825

Bishoy N. Saad DO , Ian S. Hong MD , Nicole D. Campbell MBS , Christian G. Zapf BS , Mallery Zeiman BS , Frank A. Liporace MD , Richard S. Yoon MD , Nicole Montero-Lopez MD

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引用次数: 0

摘要

目的评价6-9周早期背侧跨越钢板（DSP）取出治疗桡骨远端骨折的安全性和有效性。方法回顾性分析2019年1月至2022年12月期间，采用DSP治疗不稳定桡骨远端骨折的成人患者（≥18岁），并辅以掌侧钢板固定。纳入标准包括术后6-9周去除DSP，至少随访12个月。既往有同侧手、腕、前臂手术史或记录不完整者排除。收集人口统计学、围手术期细节和放射学测量数据（术前、术后、去除DSP后和最近随访时）。使用手臂、肩膀和手的快速残疾问卷评估功能结果。结果纳入17例患者，平均年龄53.3±21.7岁，体重指数27.1±4.2 kg/m2。去除DSP的平均时间为6.97±1.1周。2R3C3.2 AO/OTA分类是最常见的骨折类型（59%）。x线评估显示持续的解剖排列和骨折愈合。手臂、肩部和手部的平均短期快速残疾得分为18.9，为轻度残疾。在90天和1年随访中分别有18%和29%的患者出现并发症，主要是由于感觉异常和浅表伤口问题。本研究证实了在6-9周时去除DSP的安全性和有效性，其临床结果与传统的12- 16周时间线相当。未来的研究可以评估早期钢板取出是否允许加速康复方案，更早的恢复工作时间，以及它在减少术后僵硬方面的潜力。研究类型/证据水平治疗性IV。

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Early Removal of Dorsal Spanning Plate With Supplemental Distal Radius Fixation: Safety and Efficacy

Purpose

The purpose of the study was to evaluate the safety and efficacy of early dorsal spanning plate (DSP) removal at 6–9 weeks in the management of distal radius fractures.

Methods

A retrospective review of adult patients (≥18years) treated with DSP with or without supplemental volar plate fixation for unstable distal radius fractures between January 2019 and December 2022 was conducted. Inclusion criteria included DSP removal 6–9 weeks after surgery and a minimum of the 12-month follow-up. Patients were excluded if they had previous ipsilateral hand, wrist, or forearm surgery or incomplete records. Demographics, perioperative details, and radiographic measurements were collected (before surgery, immediate after surgery, immediately following DSP removal, and at the most recent follow-up). Functional outcomes were assessed using the quick disabilities of the arm, shoulder, and hand questionnaire.

Results

Seventeen patients were included (mean age: 53.3 ± 21.7 years, body mass index: 27.1 ± 4.2 kg/m²). The average time to DSP removal was 6.97 ± 1.1weeks. The 2R3C3.2 AO/OTA classification was the most commonly observed fracture pattern (59%). Radiographic assessments indicated sustained anatomic alignment and fracture healing. The mean short-term quick disabilities of the arm, shoulder, and hand score was 18.9, indicating mild disability. Complications within 90 days and at the 1-year follow-up were observed in 18% and 29% of the patients, respectively, predominantly because of paresthesia and superficial wound issues.

Conclusions

This study confirmed the safety and efficacy of DSP removal at 6–9 weeks, with clinical outcomes comparable with traditional 12-week to 16-week timelines. Future studies could evaluate whether earlier plate retrieval allows for an accelerated rehabilitation protocol, an earlier return-to-work timeline, as well as its potential in reducing postoperative stiffness.