桡骨远端骨折掌侧接骨板内固定微创手术的疗效分析

Curative effect analysis of minimally invasive surgery on treatment of distal radius fracture with palm-side plate fixation

目的比较不切开与切开旋前方肌对桡骨远端骨折掌侧钢板内固定手术疗效的影响。方法选取2014年2月-2018年3月经影像学检查确诊的桡骨远端骨折56例,按随机数字表法将上述患者分为两组,不切开组28例(术中不切开旋前方肌)和切开组28例(术中切开旋前方肌)。术后根据影像学分析骨折愈合情况、内固定放置是否良好;术后3个月比较两组在腕部VAS评分、腕部活动度以及腕关节功能评分的差异。结果不切开组手术操作时间、术中出血量以及影像学骨折愈合时间均少于切开组(P<0.05);不切开组的尺偏、桡偏、旋前和旋后功能明显高于切开组(P<0.05);术后6周复查时,切开组VAS评分和Gartland-Werley评分均高于不切开组(P<0.05)。术后3个月,两组比较差异无统计学意义(P>0.05)。两组并发症发生率无显著差异(P>0.05)。结论不切开旋前方肌的掌侧接骨板内固定术安全有效,可保护屈肌腱以及缩短康复时间,提高桡骨远端骨折的临床疗效,更有利于患者康复,是一种理想手术方式。

Objective To investigate the influence of incision or non-incision of the pronator quadratus in the fixation with palm-side plate for distal radius fracture.Methods Fifty-six patients with distal radius fractures diagnosed by radiographic examination were selected.The patients were randomly divided into two groups,according to the random number table:non-incision group(n=28)and incision group(n=28).According to the imaging to analyse of fracture healing and whether internal fixation was good or no.The difference of VAS score,wrist activity and wrist function score was compared between the two groups at 3 months after operation.Results The operation time,intraoperative blood loss and fracture healing time of non-incision group were less than that of the incision group(P<0.05).The function of ulnar deviation,radial deviation,pronation and supination at non-incision group was significantly higher than that of the incision group(P<0.05).At 6 weeks after the operation,the VAS score and GartlandWerley score of the incision group were higher than that of the non-incision group(P<0.05).At 3 months after the operation the difference between the two groups was not statistically significant(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion It is safe to effectively protect the flexor tendon and shorten the recovery time and improve the clinical curative effect of the distal radius fractures in non-incision pronator quadratws operation.It is more beneficial to the patient’s recovery and is an ideal operation.