小儿桡骨远端带扣骨折的循证治疗

Daniel A. Cornejo
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引用次数: 0

摘要

桡骨远端骨折是16岁以下儿童最常见的骨折。桡骨远端骨折的常见类型是带扣或环状骨折。这些损伤的传统治疗包括铸造和连续的x射线成像,以评估正确的愈合和保持对齐。然而,对这些损伤模式的研究表明,这些骨折本质上是稳定的,移位的发生率非常低。这些研究认为,环面骨折可以在患者护理人员不需要后续检查或成像的情况下停止使用可拆卸支架进行治疗。一项对过去5年相关文献的综述得出结论,在患有急性桡骨环骨折的儿科患者中,使用可移除支架治疗且无计划随访的患者与使用硬石膏和重复临床评估治疗的患者的临床结果相同。实施这种循证治疗可以显著改善患者护理,减少不必要的随访和成像,同时最大限度地减少患者及其护理人员的治疗成本和缺课/工作日。
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Evidence-Based Management of Pediatric Distal Radius Buckle Fractures
Distal radius fractures are the most common fracture in children younger than 16 years. A common pattern of distal radius fractures is the buckle or torus fracture. Traditional treatment of these injuries involved casting with serial x-ray imaging to evaluate for proper healing and maintained alignment. Studies of these injury patterns, however, suggest that these fractures are inherently stable and have a very low incidence of displacement. These studies posit that torus fractures can be treated definitively in a removable brace that can be discontinued by the patient's caregiver without the need for follow-up examinations or imaging. A review of pertinent literature from the past 5 years concluded that, in pediatric patients with acute radial torus fractures, clinical outcomes were equivalent between patients treated with removable braces and no scheduled follow-up and those treated with hard casting and repeat clinical evaluation. Implementation of this evidence-based treatment can significantly improve patient care by reducing unneeded follow-ups and imaging while minimizing the cost of treatment and missed school/work days by patients and their caregivers.
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