掌侧入路切开复位内固定治疗C型桡骨远端骨折的临床体会

Clinical Experience of Open Reduction and Internal Fixation in Treatment of Type C Distal Radius Fractures by Palm Side Approach

目的探讨掌侧入路切开复位内固定治疗C型桡骨远端骨折的临床效果。方法选择2013年1月-2015年12月我院收治的AO/ASIF分型为C型的桡骨远端骨折患者70例,按照随机数字表法分为2组。其中观察组35例采用掌侧入路切开复位内固定术,对照组35例则采用背侧入路。结果术后3个月两组X线测量值掌倾斜、尺偏角及桡骨高度比较差异均无统计学意义（P〉0.05）。观察组术后发生拇长伸肌肌腱刺激征2例、肌腱粘连1例,少于对照组发生肌腱粘连7例、拇长伸肌肌腱刺激征5例,差异有统计学意义（P〈0.05）。结论掌侧入路切开附属内固定治疗C型桡骨远端骨折可获得与背侧入路相同的手术效果,但掌侧入路肌腱并发症更少。

Objective To investigate the clinical effect of open reduction and internal fixation for C type of distal radius fractures by palm side approach. Methods From January 2013 to December 2015,70 cases of distal radius fractures in our hospital were divided into 2 groups according to the random number table method. In the observation group,35 cases were treated by open reduction and internal fixation with palm side approach,while 35 cases in control group were treated by dorsal approach. Results 3 months after surgery,two groups of radiographic measurements palmar tilt,ulnar deviation and radial height showed no significant difference（P〈0.05）. Occurrence of extensor tendon of the patients in the observation group of 2 cases,1 cases of irritation of tendon adhesion,less than that of the control group had tendon adhesion in 7 cases,extensor tendon irritation in 5 cases,the difference was statistically significant（P〈0.05）. Conclusion In the treatment of type C distal radius fractures,the treatment of distal radial fractures can be obtained with the same surgical effect as the dorsal approach.