微创经皮钢板接骨术与Henry入路钢板内固定治疗老年桡骨远端骨折的疗效比较研究

Comparative study of minimally invasive percutaneous plate osteosynthesis and Henry approach plate fixation in the treatment of distal radius fractures in the elderly

目的探讨微创经皮钢板接骨术(MIPPO)与Henry入路钢板内固定治疗老年桡骨远端骨折的疗效及安全性。方法 2012年2月—2016年10月东莞康华医院收治50例老年桡骨远端骨折患者,采用随机数字表法分为MIPPO组和Henry入路钢板内固定组(Henry组),每组各25例。其中男性20例,女性30例;年龄60~83岁,平均70.03岁。比较两组手术情况(手术时间、术中出血量、术后住院时间、骨折愈合时间)、腕关节活动范围、上肢功能评分(DASH评分)及并发症发生情况。结果 MIPPO组手术时间为(37.28±4.17)min、术后住院时间为(10.27±2.24)d,均短于Henry组[(57.68±6.38)min,(17.62±2.78)d,P<0.05],MIPPO组术中出血量(9.76±1.63)m L,少于Henry组[(19.32±3.17)m L,P<0.05];两组骨折愈合时间比较差异无统计学意义(P>0.05)。术后12个月两组腕关节掌屈、背伸、旋前、旋后范围比较差异无统计学意义(P>0.05),MIPPO组DASH评分低于Henry组(P<0.05)。MIPPO组并发症的发生率为12.00%,Henry组为8.00%,两组比较差异无统计学意义(P>0.05)。结论 MIPPO治疗老年桡骨远端骨折可显著缩短手术时间,降低术中出血量,显著改善上肢功能。

Objective To explore the curative effect and safety of minimally invasive percutaneous plate osteosynthesis （MIPPO） and Henry approach plate fixation in the treatment of distal radius fractures in the elderly. Methods Totally 50 elderly patients （20 males and 30 females aged 60-83 years） with distal radius fracture who were treated in our hospital from Feb. 2012 to Oct. 2016 were selected as the subjects. The patients were divided into MIPPO group and Henry approach internal fixation group （Henry group） using random digital table method,with 25 cases in each group. The operative conditions （operative time,intraoperative blood loss,postoperative hospitalization time,fracture healing time）,wrist range of motion,upper limb function score （DASH score） and complications were compared between the two groups. Results The operative time and postoperative hospitalization time in MIPPO group were shorter than those in Henry group（ P 〈0.05）,the intraoperative blood loss in MIPPO group was less than that in Henry group（ P 〈0.05）,and there was no significant difference in fracture healing time between the two groups（ P 〉0.05）.The ranges of wrist flexion,dorsiflexion,pronation and supination were not significantly different between the two groups at 12 months after operation（ P 〉0.05）,and the DASH score in MIPPO group was lower than that in Henry group（ P 〈0.05）.The incidence of complications was 12.00% in MIPPO group and 8.00% in Henry group,and there was no significant difference between the two groups （ P 〉0.05）. Conclusion MIPPO in treatment of distal radius fractures in the elderly can significantly shorten the operation time,reduce the amount of bleeding during in the operation,and significantly improve the function of the upper limb.