高齢者のとう骨遠位端骨折に対する観血的治療

概要

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This study was designed to evaluate the clinical results after surgery for fractrues of the distal end of the radius in the eldely patients. The average age at surgery was 73.6 years (range: 62 to 86 years) and the average follow-up period was 5.1 months. Thirteen fractures were treated by percutaneous pinning, 4 by plate, 5 by external fixation device, and 1 by corn head screws. Radial inclination, ulnar variance and palmar tilt were measured on X-ray films at the initial visit, after surgery, and at the final follow-up, in order to evaluaet the loss of reduction. The subjective gradings by Saito's point system were excellent in 4 cases, good in 11, fair in 4, and poor in 4. There was a significatnt difference between the average value of the radius shortening after surgery (1.6mm) and at the final follow-up (4.0mm). Particularly, the shortening was significant in the cases treated by percutaneous pinning, probably because of bone defect and osteoporosis. We think that the indication of percutaneous pinning for elderly patients should be restricted, and the use of the plate or external fixation device, with bone graft or any other supplement, should be encouraged.
西日本整形・災害外科学会の論文