Management of distal radius fractures using closed-incision negative pressure wound therapy. Retrospective study.



Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj Negative Pressure Wound Therapy Journal,
Fakulta / Pracoviště MU

Lékařská fakulta

Klíčová slova fracture distal radius osteosynthesis volar locking plate SSI ciNPT
Popis Negative pressure wound therapy has proven to be an ecient tool in the provision of temporary wound coverage in cases where definitive primary wound coverage is impossible. This initial achievement led to the use of NPWT as an incisional dressing in wounds that could be primarily closed, but posing high risk due to the amount of soft-tissue injury, location of the fracture, or high BMI. Distal radius fracture is one of the most common injuries, especially in elderly patients. Typically, fractures occur in the osteoporotic bone as a result of low-energy trauma. Conservative treatment is still dominant in the management of distal radius fractures. In general, displaced unstable fractures or fractures that fail conservative treatment are indicated for surgical therapy. In our study, we present ten-year-experience of distal radius fracture management at our department. Methods: Detailed analysis of retrospective data obtained from the hospital information system was carried out. The study included patients operated on at our department from January 1, 2010, to December 31, 2019. We evaluated age, gender, surgical approach, complications, and implant removal. Results: in total, 207 patients were evaluated, women to men ratio was 2:1 (144:63 cases). The mean age was 56 years (women 62 years, men 45 years). Volar surgical approach with volar locking plate osteosynthesis predominated (199 cases). The complication rate was 10% with implant-associated complications being the most common (3.7%). The implant removal rate was 17%. No surgical site infection (SSI) was detected. Closed incision negative pressure therapy (ciNPT) was applied in highrisk wounds. Conclusion: Volar locking plate osteosynthesis is a method of choice with a low complication rate. Implant removal is not routinely indicated. Preventive application of ciNPT is beneficial in high-risk wounds, but diagnosis of fracture of the distal forearm according to the occurrence in our analysis is not essential for preventive use of NPWT, since the incidence of wound infection, in high-risk patients, is extremely low.
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