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DOI: 10.1055/s-0034-1385926
Arthroskopisch assistierte Versorgung dorsal dislozierter distaler intraartikulärer Speichenfrakturen – Technik und Ergebnisse
Arthroscopically Assisted Osteosynthesis of Dorsally Tilted Intraarticular Distal Radius Fractures – Technique and ResultsPublication History
eingereicht 19 June 2014
akzeptiert 12 July 2014
Publication Date:
07 October 2014 (online)
Zusammenfassung
Die vorliegende Arbeit beschreibt die Indikation und Technik der arthroskopisch unterstützten Verplattung dorsal dislozierter intraartikulärer Radiusfrakturen. Dabei wird auf ein bewährtes Repositionsverfahren eingegangen, die Klassifikation von Begleitverletzungen beschrieben und deren Therapiemöglichkeiten diskutiert. Klinische und radiologische Ergebnisse einer Fallserie von 17 Patienten werden präsentiert. Die DASH- bzw. PRWE Werte lagen 2,5 Jahre nach der Operation bei 4,9 und 6,0. Die aktive Beweglichkeit in der Sagittalebene erreichte 123° und somit 87% der gesunden Gegenseite, in der Frontalebene wurden 51° erzielt, was 98% der Gegenseite entspricht. Die Unterarmdrehung war mit 163° und 97% annähernd seitengleich. Der dorsopalmare Gelenkwinkel zum Ausheilungszeitpunkt betrug durchschnittlich 6°, der radioulnäre Gelenkwinkel 23° und die ulnare Varianz −1,2 mm. Der skapholunäre Gelenkspalt wurde mit 1,6 mm, der skapholunäre Gelenkwinkel mit 57° gemessen.
Abstract
The present paper describes the indication and application of an arthroscopically assisted osteosynthesis for distal radius fractures. Visualisation of articular incongruency is emphasised with special regard to articular fracture fragment reduction. In addition to that, classification of soft tissue injuries and treatment options are discussed. The final clinical and radiological results of 17 patients are presented: DASH and PRWE averaged 4.9 and 6.0 respectively. Active range of motion measured 123° for flexion/extension, 51° for radial and ulnar deviation and 163° for pronosupination, which is 87%, 98% and 97%, respectively, compared with the opposite wrist. Radial inclination at final follow-up was 23°, palmar tilt measured 6° and ulnar variance averaged −1.2 mm. The scapholunate gap at follow-up was 1.6 mm, and the scapholunate angle measured 57°.
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