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在65岁或以上的患者中进行非手术治疗与飞行锁定涂层 (DRIFT试验):随机对照试验

Teemu P Hevonkorpi^1,2, Antti P Launonen¹, Aleksi Reito¹

¹Department of Orthopaedics, Tampere University Hospital, Tampere, Finland.

|September 5, 2025

概括

对于患有远端半径骨折的老年人来说,如果最初失去对齐,飞行锁定板 (VLP) 可能会略有改善手腕功能. 然而,在非手术治疗期间,VLP对骨折失去对齐没有明显的益处.

科学领域:

骨科手术
创伤学
老年医学

背景情况:

在老年患者中最优地治疗远半径骨折 (DRF),特别是非手术治疗期间早期不对齐的骨折.
对于这些特定骨折病例的最佳方法存在知识差距.

研究的目的:

将非手术治疗与手术治疗与VLP进行比较,主要用于非手术治疗期间不对齐的DRF和早期不对齐的DRF.
使用患者指定的手腕评估 (PRWE) 评分来评估12个月的手腕功能.

主要方法:

预期的多中心随机对照试验 (DRIFT试验) 涉及65岁以上的背部移位A型或C型A型DRF患者.
如果在封闭降低后或在早期随访期间失去对齐,患者被随机分配到非手术治疗或VLP.
主要结局是12个月后的PRWE,使用线性混合模型进行分析.

主要成果:

在主要不对齐的DRF中,VLP显示了PRWE的统计学上显著但临床上很小的改善 (平均差异为- 9. 6分),低于临床上重要的最小差异 (MCID).
在早期不对齐的DRF中没有观察到VLP的显著益处 (平均差异为- 6. 2分).
与治疗相关的不良事件在不同组中相似.

结论:

用VLP进行手术可能会为主要不对齐的DRF提供轻微的功能优势,尽管不符合MCID.
手术似乎对早期失调的DRF没有好处.
治疗决策应以初始骨折减少为基础,在非手术治疗中可能质疑早期放射性随访的必要性.

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