微创经皮钢板接骨术与Henry入路钢板内固定治疗桡骨远端骨折的疗效比较

Comparison of effect of percutaneous minimal invasive plate osteosynthesis and Henry approach palmar locking plate internal fixation in treating distal radial fractures

目的 对比分析微创经皮钢板接骨术与Henry入路钢板内固定治疗桡骨远端骨折的临床疗效.方法 选取我院于2011年3月～2012年10月收治的46例桡骨远端骨折的患者,将所有患者随机分为实验组与对照组,两组均为23例.实验组接受微创经皮钢板接骨术,对照组接受Henry入路钢板内固定,对比分析两组的临床疗效.结果 实验组术中出血及手术时间明显少于对照组[（37.83±2.96）mL、（37.52±10.17）min vs （53.24±7.61）mL、（66.32±9.95）min;t=9.051、9.708,P=0.000、0.000],两组术后并发症发生率的差异比较无统计学意义（13.0% vs 8.7%;χ2=1.247,P=0.264）;实验组与对照组骨折愈合时间及术后半年腕关节主动活动度的差异比较无统计学意义[（7.83±1.17）周,（71.92±7.31）°、（65.46±4.35）°、（81.59±4.72）°、（77.35±6.01）° vs （7.72±1.08）周,（71.25±6.83）°、（64.26±4.92）°、（80.62±4.88）°、（76.23±5.81）°;t=0.331、0.321、0.876、0.685、0.643,P=0.742、0.750、0.386、0.497、0.524],而术后半年实验组DASH评分明显低于对照组（6.21±2.34 vs 10.86±4.18;t=4.655,P=0.000）.结论微创经皮钢板接骨术治疗桡骨远端骨折具有出血少、时间短的优势,术后患者的主观满意程度较高,但对于部分骨折分型,仍需要采用Henry入路.

Objective To compare the clinical effect of percutaneous minimal invasive plate osteosynthesis and Henry approach palmar locking plate internal fixation in treating distal radial fractures. Methods Forty-six patients with distal radial fractures who came to our hospital from March 2011 to October 2012 were randomly divided into the control group and the experimental group. The experimental group accepted the percutaneous minimal invasive plate osteosyn- thesis while the control group accepted Henry approach palmar locking plate internal fixation. Compared and analyzed the clinical effect of the two groups. Results The blood loss and operative time of the experimental group was statistically less than that of the control group [（37.83±2.96）mL, （37.52±10.17）min vs （53.24±7.61）mL, （66.32±9.95）min; t= 9.051, 9.708; P=0.000, 0.000] while the difference of postoperative complication rate between the two groups was not statistically significant （13.0% vs 8.7%;χ2=1.247, P=0.264）. The difference of healing time and wrist active activity between the two groups was not statistically significant [（7.83±1.17）weeks, （71.92±7.31）°, （65A6±4.35）°, （81.59±4.72）°, （77.35±6.01）° vs （7.72±1.08）weeks, （71.25±6.83）°, （64.26±4.92）°, （80.62±4.88）°, （76.23±5.81）°; t=0.331, 0.321, 0.876, 0.685, 0.643; P=0.742, 0.750, 0.386, 0.497, 0.524], but in six months after the operation the DASH score of the experimental group was statistically lower than that of the control group （6.21±2.34 vs 10.86±4.18; t=4.655, P=0.O00）. Conclusion Percutaneous minimal invasive plate osteosynthesis has the advantage of less bleeding and shorter operation time and the patients have higher postoperative degree of subjective satisfaction. But for some fracture type, the use of Henry approach is still required.