修复旋前方肌在桡骨远端骨折手术后功能改善研究

Analysis of functional effect of repairing pronator quadratus muscle after operation for distal radius fracture

目的:对桡骨远端骨折手术治疗中修复旋前方肌与否进行术后功能评价。方法:收集桡骨远端骨折病例45例,AO分型B、C型,均采用Henry入路切开复位钢板内固定。A组25例,骨折复位解剖钢板固定后将切开旋前方肌修复于肱桡肌旁组织。B组20例,骨折复位解剖钢板固定后将切开旋前方肌原位铺于钢板表面。术后6周、6月比较患侧与健侧关节活动范围(旋前、旋后、掌背屈)、上肢功能评分(DASH)、疼痛VAS评分。结果:术后6周AB两组间活动范围功能比较无统计学差异(P>0.05)AB组组间DASH评分比较无统计学差异(P>0.05);VAS评分比较有统计学差异(P<0.05)。术后6月患侧与健侧旋前、旋后功能比较无统计学差异(P>0.05).AB两组间旋后、旋前功能比较无统计学差异。两组间DASH评分比较无统计学差异(P>0.05);VAS评分比较无统计学差异(P>0.05)。结论:修复旋前方肌对在桡骨远端骨折术后活动范围、上肢功能无明显优势,但能减少术后早期疼痛。减少术后并发症,值得提倡。

Objective:To evaluate of upper limb function surgical treatment of the distal radius fracture repair of the pronator quadratus(PQ)muscle and no repair.Methods:Retrospectively review collected surgery for the treatment of distal radius fractures in 45 cases,AO type B,C.All via a volar approach involves surgical(Henry)Open reduction internal fixation.Group A were 25 cases,reduction of anatomic plate fixation after repair of the pronator quadratus muscle in brachioradialis muscle tissues.In group B were 20 cases,reduction of anatomic plate fixation after pronator quadratus muscle cover on the surface of the volar plate.After 6weeks,6month compared with wrist the range of motion(pronation,supination,flexion,extension),Quick Disability Arm,Shoulder,and Hand(DASH),Wrist pain visual analog scale(VAS)score.Results:There was no significant difference between the two groups range of motion(ROM),DASH score after surgery 6 week(P>0.05);VAS score significant difference(P<0.05).No significant difference in ROM,DASH score,VAS score between the complete and incomplete PQ repair groups after surgery 6 month(P>0.05).Conclusion:The repair of the pronator quadratus muscle has no obvious advantage on the range of motion,activity of the upper limb function,but it can reduce the early postoperative pain.Reduce postoperative complications.It is a good choice.