短臂石膏与长臂石膏治疗桡骨远端关节内骨折的炎症、影像学及临床疗效差异

Made Asmara Yoga, Ketut Siki Kawiyana, Made Bramantya Karna
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摘要

背景:桡骨远端骨折是最常见的上肢骨折,占所有肢体骨折的20%。根据美国骨科学会的桡骨远端骨折指南,对于复位良好的桡骨远端骨折,可以采用保守治疗。目的:本研究的目的是比较短臂石膏(SAC)和长臂石膏(LAC)在治疗桡骨远端关节内骨折中的保守治疗效果。方法:对24例接受SAC和LAC手术的关节内远端骨折患者进行了连续抽样的前瞻性队列观察研究。测量的参数包括白细胞介素-6 (IL-6)评分、尺侧方差(UV)、背侧倾斜(DT)、关节偏移(SO)、放射愈合评分系统(RUSS)和患者评定腕关节评估(PRWE)评分。结果:患者以46岁男性为主,0 ~ 24岁时平均IL-6水平为1139.23±266.82 SAC和1082.64±255.85 LAC, 48 h时IL-6水平为102.98±39.31 SAC和118.38±39.15 LAC;2例SAC患者和1例LAC患者在第2周获得了基于UV、DT、SO的不可接受的降低,这与每次随访没有显著差异;RUSS: SAC 6.08±0.76,LAC 5.71±0.61;PRWE SAC 73.23±4.42,LAC 71.86±4.07。经统计分析,SAC组与LAC组IL-6、UV、DT、SO、RUSS、PRWE水平差异无统计学意义(p >0.05)。结论:SAC保守治疗可能是桡骨远端骨折固定的一种选择。
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Differences in Inflammation, Radiological and Clinical Outcomes between Short Arm Cast and Long Arm Cast in Intraarticular Distal Radius Fractures
BACKGROUND: Distal radius fractures are the most common upper extremity fractures with a prevalence of 20% of all limb fractures. According to the distal radius fracture guidelines by the American Academy of orthopedic surgeons, conservative therapy can be used in the management of distal radius fractures that are well reduced. AIM: The purpose of this study was to compare conservative therapy of short arm cast (SAC) and long arm cast (LAC) in the management of intraarticular distal radius fractures. METHODS: A prospective cohort observational study with consecutive sampling was conducted on 24 intraarticular distal fracture patients who underwent SAC and LAC procedures. The parameters measured were Interleukin-6 (IL-6) score, ulnar variance (UV), dorsal tilt (DT), articular step-off (SO), radiological union score system (RUSS), and patient-rated wrist evaluation (PRWE) score. RESULTS: The dominance of patients was males aged 46 years, with an average IL-6 levels at 0–24 was 1139.23 ± 266.82 SAC and 1082.64 ± 255.85 LAC, and IL-6 levels at 48 h was 102.98 ± 39.31 SAC and 118.38 ± 39.15 LAC; 2 patients with SAC and 1 patient with LAC obtained unacceptable reduction at week 2 based on UV, DT, SO which did not differ significantly from each follow-up; RUSS 6.08 ± 0.76 SAC and 5.71 ± 0.61 LAC; and PRWE 73.23 ± 4.42 SAC and 71.86 ± 4.07 LAC. Based on statistical analysis, there were insignificant differences in IL-6, UV, DT, SO, RUSS, and PRWE levels between the SAC and LAC groups (p > 0.05). CONCLUSION: Conservative therapy with SAC may be an option for immobilization of distal radius fracture similar to LAC.
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期刊介绍: Open Access Macedonian Journal of Medical Sciences (OAMJMS) [formerly known as Macedonian Journal of Medical Sciences] is a top-tier open access medical science journal published by the ID Design 2012/DOOEL Skopje, Rajko Zhinzifov No 48, 1000 Skopje, Republic of Macedonia. OAMJMS is an international, modern, general medical journal covering all areas in the medical sciences, from basic studies to large clinical trials and cost-effectiveness analyses. We publish mostly human studies that substantially enhance our understanding of disease epidemiology, etiology, and physiology; the development of prognostic and diagnostic technologies; trials that test the efficacy of specific interventions and those that compare different treatments; and systematic reviews. We aim to promote translation of basic research into clinical investigation, and of clinical evidence into practice. We publish occasional studies in animal models when they report outstanding research findings that are highly clinically relevant. Our audience is the international medical community as well as educators, policy makers, patient advocacy groups, and interested members of the public around the world. OAMJMS is published quarterly online version. The Open Access Macedonian Journal of Medical Sciences (OAMJMS) publishes Medical Informatics, Basic Science, Clinical Science, Case Report, Brief Communication, Public Health, Public Policy, and Review Article from all fields of medicine and related fields. This journal also publishes, continuously or occasionally, the bibliographies of the members of the Society, medical history, medical publications, thesis abstracts, book reviews, reports on meetings, i­n­formation on future meetings, important events and dates, and various headings which contribute to the development of the corresponding scientific field.
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