방형 회내근 보존법을 이용한 심한 원위 요골 분쇄 골절의 치료 결과

Abstract

Purpose: We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach.Materials and Methods: Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduc-tion of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome.Results: Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5o; the average volar tilt, 7.57o; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were ‘Fair’ in 1 patient, ‘Good’ in 4, and ‘Excellent’ in 9.Conclusion: We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.