Eficácia do tratamento com placas volares em fraturas da borda dorsal do rádio distal

Resumo

Objetivo Avaliar a eficácia das placas volares do rádio distal em casos de fragmentos dorsais na borda cubital (BC) e no tubérculo de Lister (TL).

Métodos Estudo retrospectivo que incluiu pacientes com fraturas do rádio distal (FRDs) com fragmentos dorsais na BC e no TL tratados com placas volares. Foram excluídos pacientes com fraturas da faceta semilunar, razão de fragmentos da BC inferior a 25% e tratamento com placas dorsais. As medidas radiográficas e tomográficas incluíram comprimento radial (CR), inclinação radial (IR), variância cubital (VC), inclinação palmar (IP), áreas de fragmentos, razão de fragmentos da BC e luxações. Foram avaliados as pontuações na classificação de Gartland Werley (GW) e no questionário Disabilities of the Arm, Shoulder and Hand (DASH), além da força de preensão e da amplitude de movimento (ADM).

Resultados O estudo incluiu 17 homens e 5 mulheres (idade média: 39,7 ± 10,7 anos). Os fragmentos da BC e do TL apresentaram áreas médias de 1,62 ± 0,73 cm² e razão de fragmentos da BC de 0,4 ± 0,1. As taxas de fixação dos fragmentos da BC e do TL foram de 18,12% e 31,8%, respectivamente. Melhoras na IR, na VC e na IP foram observadas após a cirurgia. As médias das pontuações na GW e no DASH foram de 2,1 ± 2,0 e 4,3 ± 3,2, respectivamente. A força de preensão no lado operado foi de 89,5 ± 9,8% em comparação ao lado sadio, e pelo menos 90,9% dos pacientes alcançaram ADM adequada.

Conclusão Embora as placas volares sejam o tratamento padrão para FRDs intra-articulares, fragmentos dorsais deslocados podem afetar os resultados. Mini-incisões dorsais podem auxiliar na fixação de fragmentos da BC de tratamento difícil com placas volares, para preservar a saúde das articulações.

Palavras-chave

estudos retrospectivos - fixação interna de fraturas - fraturas do rádio - placas ósseas

Contribuições dos Autores

Cada autor contribuiu individual e significativamente para o desenvolvimento deste artigo: UB, EA e YY pesquisaram a literatura e conceberam o estudo; YY e EA participaram do desenvolvimento do protocolo; ÖHK obteve a aprovação ética; MDS e ÖHK participaram do recrutamento de pacientes e da análise de dados; MDS e UB escreveram o primeiro rascunho do manuscrito; e MA supervisionou, revisou e editou o estudo. Todos os autores revisaram e editaram o manuscrito e aprovaram sua versão final.

Trabalho desenvolvido na Divisão de Cirurgia de Mão e Membro Superior, Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Ankara University, Altındağ, Ankara, Turquia.

Publikationsverlauf

Eingereicht: 19. Dezember 2023

Angenommen: 23. Juni 2024

Artikel online veröffentlicht:
21. Dezember 2024

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