不同入路重建钢板内固定术治疗尺桡骨双骨折临床疗效比较

Clinical efficacy of different reconstruction plate internal fixation for the treatment of double fractures of the ulna and radius

目的探讨不同入路重建钢板内固定手术治疗尺桡骨双骨折的临床疗效。方法选择2013年1月~2015年6月在我科治疗的尺桡骨双骨折患者74例的临床资料进行回顾性分析,其中31例背侧单切口重建钢板内固定,43例患者采用桡尺双侧切口重建钢板内固定。比较两组平均手术时间、术中过出血量、手术切口长度、术后5d疼痛程度,术后2、12周HSS评分。结果两组平均手术时间、平均术中出血量、平均骨折愈合时间比较差异无统计学意义（P〉0.05）;双侧切口长度显著长于单侧切口组,术后第5天平均VAS评分显著高于单侧切口组,差异有统计学意义（P〈0.01）。术后2周,单侧切口组简易上肢功能评价评分显著高于双侧切口组,差异有统计学意义（P〈0.01）。术后12周随访,两组HSS评分差异无统计学意义（P〉0.05）。两组患者均无严重并发症发生,无手术失败病例。两组优良率比较差异无统计学意义（P〉0.05）。结论重建钢板内固定术治疗尺桡骨双侧骨折时单侧切口创伤较双侧切口更小,疼痛更轻,术后2周随访简易上肢功能评价评分更高,但在术后12周时随访前臂功能恢复相当。

Objective To compare clinical efficacy of different reconstruction plate internal fixation for the treatment of double fractures of the ulna and radius. Methods Clinical data of 74 cases with double fractures of the ulna and radius from Jan 2013 to Jun 2015 were respectively analyzed. 31 cases were treated with dorsal single incision reconstruction plate internal fixation, and 43 cases were treated with radialis and ulnar bilateral incision reconstruction plate internal fixation. Mean operative time, intraoperative blood loss, operative incision length, degree of pain 5 days after operation, HSS at 2 weeks and 12 weeks after operation of two groups were compared. Results Mean operation time, average blood loss, average fracture healing time in the two groups of two groups showed no significant difference（P〈0.05）; Length of incision of bilateral incision group was longer than unilateral incision group, and VAS 5 days after operation was higher than unilateral incision group（P〈0.01）. HSS at 2 weeks after operation of unilateral incision group wa higher than bilateral incision group（P〈0.01）. HSS at 12 weeks after operation of two groups showed no significant difference（P〈0.05）. There were no severe complications and no surgical failure cases. Excellent rates of two groups showed no significant difference（P〈0.05）. Conclusion Plate internal fixation for the treatment of double fractures of the radius and radius, Length of incision of unilateral incision is shorter than bilateral incision, less pain, and higher HSS at 2 weeks after operation, but HSS is similar at 12 weeks after operation.