Clinical outcomes in distal radial fractures with ipsilateral arteriovenous fistulas

Journal of Orthopaedic Surgery and Research

Hao-Ming Chang¹  Po-Ting Wu²  Yi-Chuan Chou³  I-Ming Jou⁴  Jui-Ming Yang⁵  Ching-Hou Ma⁶ 

[1] 0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;0000 0004 0639 0054, grid.412040.3, Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;0000 0004 0639 0054, grid.412040.3, Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Dou-Liou, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;0000 0004 0639 0054, grid.412040.3, Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;grid.410770.5, Department of Orthopedics, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;0000 0004 1797 2180, grid.414686.9, Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan;0000 0004 0637 1806, grid.411447.3, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan;0000 0004 0532 3255, grid.64523.36, Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 701, Tainan, Taiwan;Department of Orthopedic, Tainan Sin Lau Hospital, Tainan, Taiwan;0000 0004 1797 2180, grid.414686.9, Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan;0000 0004 0637 1806, grid.411447.3, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan;

关键词: Arteriovenous fistula;    Volar locking plate;    External fixation;    Henry approach;    Distal radius fracture;    Hemodialysis patients;   

DOI  :  10.1186/s13018-019-1171-4

来源: publisher

【 摘 要 】

BackgroundWe evaluated the effects on arteriovenous fistula (AVF) function and clinical outcomes in patients given cast fixation, external skeletal fixation [ESF], or volar locking plate fixation [VLPF] for an ipsilateral distal radial fracture (DRF).MethodsThirteen patients were assigned to the surgery group or the cast group; follow-up was ≥12 months. One-year clinical outcomes and serial AVF function and radiographic outcomes were recorded and analyzed.ResultsAll fractures were union and all AVFs were preserved with continuous hemodialysis. The surgery group had better immediately (radial inclination and articular step-off) and 1-year post-index procedure radiographic findings (radial height, radial inclination, volar tilting, ulnar variance, and articular step-off) and better 1-year functional outcomes (Mayo and QuickDASH score) than did the cast group. The VLPF subgroup had better QuickDASH scores and radiographic outcomes (radial inclination and ulnar variance) than did the ESF subgroup.ConclusionsOne year after the index procedure, none of the treatment affected shunt function in DRFs ipsilateral to AVFs. ESF and VLPF yielded better functional and radiographic outcomes than did cast fixation in patients with ipsilateral DRFs and AVFs.Level of EvidenceIII

【 授权许可】

CC BY