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Objetivo. Evaluar los resultados clínicos y radiográficos de una serie de fracturas de radio distal operadas y determinar los parámetros clínicos mejor valorados por los pacientes. Material y método. Estudio casos control de 58 fracturas de radio distal (56 pacientes) operadas entre los años 2000 y 2003. Se evaluaron fuerza, dolor, movilidad de muñeca, se analizaron radiográficamente las articulaciones radiocarpiana y radiocubital distal y se cumplimentó el cuestionario DASH (Disability of the Arm, Shoulder and Hand). Resultados. Las fracturas de radio distal de alta energía se asociaron con pérdidas tempranas de reducción y sexo masculino, y las de baja con mujeres posmenopáusicas. La osteosíntesis empleada comprendió agujas, placas, fijación externa y combinaciones de las tres. Obtuvieron buena puntuación en el cuestionario valores bajos de la escala analógica visual y altos de pronosupinación, y esta última se asoció a varianzas cubitales negativas o poco positivas. Conclusiones. Una amplia pronosupinación y poco dolor fueron las variables mejor valoradas por los pacientes. Por eso creemos necesario proteger la articulación radiocubital distal con independencia del estado de la radiocarpiana.
Palabras clave:
radiodistal, fractura, DASH
Purpose. Clinical and X-ray assessment of the results of a series of surgeries of the distal radius and of the clinical parameters considered of greatest value by patients. Materials and methods. A study was carried out of 58 fractures of the distal radius (56 patients) that underwent surgery from 2000 to 2003. An evaluation was made of strength, pain, wrist mobility and of x-rays of the radiocarpal and distal radiocubital joints, and a DASH (Disability of the Arm, Shoulder and Hand) questionnaire was completed. Results. High-energy distal fractures of the radius are associated with early loss of reduction and male sex and low energy ones with menopause and female sex. The methods of fixation used included k-wires, plates, external fixation and combinations of all of these. In the questionnaire good scores were obtained by low analogical visual values and high pronosupination values. The latter being associated with negative or slightly positive values of cubital variance. Conclusions. Little or no pain and good pronosupination were the variables most valued by the patients. Therefore, we think it is necessary to protect the distal radiocubital joint whatever the status of the radiocarpal joint.
Keywords:
distal radius, fracture, DASH
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