风险因素与远距离半径骨折的崩相关的风险因素在老年成人 volar 锁定板固定后
1Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.
背景：本研究旨在确定使用掌侧锁定钢板治疗老年患者桡骨远端骨折时，与再移位或塌陷相关的危险因素。方法：我们对131名年龄≥65岁、接受掌侧锁定钢板固定的桡骨远端骨折患者进行了回顾性分析。根据以下标准将塌陷分为三类：“桡侧塌陷”定义为桡骨倾斜角减少幅度最大的十分位数患者；“背侧塌陷”根据侧位或25°倾斜侧位影像上的掌倾角确定；“高度塌陷”则依据桡骨高度判断。为明确与这三种塌陷类型相关的因素，我们比较了每种塌陷类型与非塌陷手腕之间的临床和影像学参数。结果：背侧塌陷无显著相关因素，而桡侧塌陷则与骨质疏松这一显著差异因素相关。高度塌陷组与年龄较大、高能量损伤机制的发生率较高、末次随访时屈伸活动范围受限以及关节面与远端螺钉之间的距离较大相关。结论：掌侧锁定钢板可有效预防三种类型的塌陷。高度塌陷组包括年龄较大、受伤机制为高能量损伤以及末次随访时屈伸活动范围受限的患者。为预防塌陷，必须将尽可能长的远端螺钉置入关节下骨下方。证据等级：四级（治疗性）。
背景：本研究旨在确定使用掌侧锁定钢板治疗老年患者桡骨远端骨折时，与再移位或塌陷相关的危险因素。方法：我们对131名年龄≥65岁、接受掌侧锁定钢板固定的桡骨远端骨折患者进行了回顾性分析。根据以下标准将塌陷分为三类：“桡侧塌陷”定义为桡骨倾斜角减少幅度最大的十分位数患者；“背侧塌陷”根据侧位或25°倾斜侧位影像上的掌倾角确定；“高度塌陷”则依据桡骨高度判断。为明确与这三种塌陷类型相关的因素，我们比较了每种塌陷类型与非塌陷手腕之间的临床和影像学参数。结果：背侧塌陷无显著相关因素，而桡侧塌陷则与骨质疏松这一显著差异因素相关。高度塌陷组与年龄较大、高能量损伤机制的发生率较高、末次随访时屈伸活动范围受限以及关节面与远端螺钉之间的距离较大相关。结论：掌侧锁定钢板可有效预防三种类型的塌陷。高度塌陷组包括年龄较大、受伤机制为高能量损伤以及末次随访时屈伸活动范围受限的患者。为预防塌陷，必须将尽可能长的远端螺钉置入关节下骨下方。证据等级：四级（治疗性）。
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