非移位性或细微移位性骨折
这些骨折预后均良好。 经过4 ~ 6 周的固定及作业治疗,尽管完全恢复还需要几个月,但运动和力量可在 8-12 周内开始恢复。
移位性骨折
切开复位内固定术比经皮固定具有更好的短期疗效。 更长期的随访证实有相似的结果。[36]Koval KJ, Harrast JJ, Anglen JO, et al. Fractures of the distal part of the radius: the evolution of practice over time: where's the evidence? J Bone Joint Surg Am. 2008;90:1855-1861.http://www.ncbi.nlm.nih.gov/pubmed/18762644?tool=bestpractice.com[37]Rozental TD, Blazar PE, Franko OI, et al. Functional outcomes for unstable distal radial fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation: a prospective randomized trial. J Bone Joint Surg Am. 2009;91:1837-1846.http://www.ncbi.nlm.nih.gov/pubmed/19651939?tool=bestpractice.com[38]Egol K, Walsh M, Tejwani N, et al. Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. J Bone Joint Surg Br. 2008;90:1214-1221.http://www.ncbi.nlm.nih.gov/pubmed/18757963?tool=bestpractice.com
结果测定
传统观点认为这些骨折的结局均令人满意。然而,虽然通常来说结果令人满意,但也有例外。此外,令人满意的结局的定义可能取决于多个因素,包括患者年龄、职业和功能要求、损伤类型、属于高能量还是低能量损伤、患肢是否为优势侧、有无伴随损伤、随访持续时间以及定义结局所采用的评估工具。
医生评估标准转成患者评估标准的情况越来越多。 包括患者额定手腕评估(PRWE)和预后工具如臂、肩和手残疾(DASH)。[39]Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder and hand)(corrected). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29:602-608.http://www.ncbi.nlm.nih.gov/pubmed/8773720?tool=bestpractice.com[40]MacDermid JC, Turgeon T, Richards RS, et al. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma. 1998;12:577-586.http://www.ncbi.nlm.nih.gov/pubmed/9840793?tool=bestpractice.com