不同入路内固定术治疗桡骨远端C型骨折的效果

Effect of internal fixation through different approaches in the treatment of type C distal radius fractures

目的:观察Henry入路与掌侧小切口入路锁定钢板内固定术在桡骨远端C型骨折治疗中的应用效果。方法:选取68例桡骨远端C型骨折患者作为研究对象,按照治疗方法分为微创组(n=35)和常规组(n=33),常规组接受Henry入路锁定钢板内固定术,微创组接受掌侧小切口入路锁定钢板内固定术,比较两组的临床指标、术后1个月腕关节活动度、上肢功能评分表(DASH)、视觉模拟评分法(VAS)评分及并发症发生情况。结果:与常规组相比,微创组切口长度小、出血量少、手术时间及住院时间短,且掌屈、背伸、旋前度高,术后1个月DASH、VAS评分低(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:掌侧小切口入路锁定钢板内固定术在桡骨远端C型骨折治疗中具有创口小、出血少、手术时间短、恢复快等优势,更有利于患者的康复。

Objective:To observe the application effect of locking plate internal fixation through Henry and volar small-incision approach in the treatment of type-C distal radius fractures.Methods:Sixty-eight patients with type-C distal radius fractures were retrospectively selected and divided into a minimally invasive group(n=35)and a routine group(n=33)according to their different treatment methods.The routine group underwent locking plate internal fixation through Henry approach while the minimally invasive group underwent locking plate internal fixation through volar small-incision approach.The clinical indexes,wrist mobility at 1 month after surgery,scores of disabilities of arm,shoulder and hand(DASH)and visual analogue scale(VAS),and complications were compared between the two groups.Results:Compared with the routine group,the minimally invasive group had smaller incision,less blood loss,shorter operation and hospitalization time,higher palm flexion,back extension and pronation,and lower DASH and VAS scores at one month after operation(P<0.05).There were no significant differences in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Locking plate internal fixation through volar small-incision approach for the treatment of type-C distal radius fractures has such advantages as small wound,less blood loss,short operation time and fast recovery and is of benefit to promoting recovery of patients.