固定时间对桡骨远端关节内骨折手术治疗结果的影响

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-11-01 Epub Date: 2023-05-26 DOI:10.1177/15589447231174642
A Jordan Grier, Kallie J Chen, Alexandra V Paul, Cynthia L Green, Marc J Richard, David S Ruch, Tyler S Pidgeon
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引用次数: 0

摘要

背景:近来,桡骨远端骨折(DRF)手术治疗的发生率有所上升,但手术固定的最佳时机仍不明确。我们假设(1) 增加关节内 DRF 的固定时间会增加术后并发症的可能性;(2) 增加从受伤到固定的时间会导致手术时间延长和活动范围 (ROM) 结果变差:我们回顾性研究了10.5年间在我院接受闭合性关节内DRF切开复位内固定术(ORIF)的284名成年患者的299处骨折。我们收集了患者的人口统计学信息、从受伤到手术的时间(TTS)、手术时间、止血带时间、并发症和最终术后ROM,并建立了逻辑回归模型来预测术后并发症的风险:结果:27 名患者(9.0%)出现了术后并发症。所有患者的中位 TTS(Q1-Q3)为 7.0(4.0-12.0)天。术后早期出现并发症的患者的 TTS 中位数(10.0 天)明显长于未出现并发症的患者(7.0 天)。TTS时间较长的患者更容易出现并发症(几率比为1.11;95%置信区间为1.04-1.19;P = .006)。止血带时间和最终腕关节ROM与TTS无关。逻辑回归分析发现,早期并发症发生率在伤后7.0天翻了一番(从3.5%增至6.9%):结论:关节内桡骨远端骨折患者最好在伤后7至10天内进行手术固定,以最大限度地降低术后早期并发症的风险。止血带时间和最终ROM与手术时间无关。
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Impact of Time to Fixation on Outcomes of Operative Treatment of Intra-articular Distal Radius Fractures.

Background: The incidence of operative treatment of distal radius fractures (DRFs) has increased recently, but the optimal timing for surgical fixation remains unclear. We hypothesized that: (1) an increase in time to fixation of intra-articular DRFs would increase the likelihood of postoperative complications; and (2) increased time from injury to fixation would lead to longer surgical time and worse range of motion (ROM) outcomes.

Methods: We retrospectively reviewed 299 fractures in 284 adult patients who underwent open reduction and internal fixation (ORIF) of a closed, intra-articular DRF at our institution over a 10.5-year period. Demographic information, time to surgery (TTS) from injury, surgical time, tourniquet time, complications, and final postoperative ROM were collected for logistic regression modeling to predict the risk of postoperative complication.

Results: Twenty-seven (9.0%) patients experienced postoperative complications. The median TTS (Q1-Q3) for all patients was 7.0 (4.0-12.0) days. Patients who experienced an early postoperative complication had significantly longer median TTS (10.0 days) than those who did not (7.0 days). Patients with longer TTS were more likely to experience a complication (odds ratio, 1.11; 95% confidence interval, 1.04-1.19; P = .006). Tourniquet time and final wrist ROM were not related to TTS. A logistic regression analysis found that early complication rate doubles at 7.0 days after injury (from 3.5% to 6.9%).

Conclusions: Patients with operative intra-articular distal radius fractures should ideally be fixed within 7 to 10 days of injury to minimize the risk of early postoperative complications. The tourniquet time and final ROM were not associated with time to surgery.

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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
期刊最新文献
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