关节镜辅助下内固定术治疗桡骨远端骨折的临床研究

Clinical Study of Arthroscopic Assisted Internal Fixation for Distal Radius Fracture

目的:探讨关节镜辅助下内固定术对桡骨远端骨折(DRF)患者腕功能及并发症的影响。方法:选取2016年1月至2019年1月DRF患者100例,依据术式分为A组和B组(各50例),A组予切开复位内固定术,B组予关节镜辅助下内固定术,比较两组围术期情况、腕关节活动度、腕功能、并发症。结果:B组术中出血量和住院时间、骨折愈合时间明显少于A组,B组手术时间明显长于A组,差异有统计学意义(P<0.05);B组术后6个月屈曲、伸展、旋前、旋后、桡偏、尺偏等腕关节活动度和腕功能优良率明显高于A组,差异有统计学意义(P<0.05);A组和B组术后12个月屈曲、伸展、旋前、旋后、桡偏、尺偏等腕关节活动度和腕功能优良率比较,差异无统计学意义(P>0.05);B组并发症发生率明显低于A组,差异有统计学意义(P<0.05)。结论:关节镜辅助下内固定术可减少DRF患者手术创伤及并发症,有利于促进患者术后康复,且可改善患者近期腕关节活动度、腕功能,值得临床推广应用。

Objective:To investigate the effect of arthroscopic assisted internal fixation on the wrist function and complications in patients with distal radius fracture(DRF).Methods:100 patients with DRF were selected from January 2016 to January 2019,they were divided into group A(n=50)and group B(n=50).Group A received open reduction and internal fixation,group B received arthroscopic assisted internal fixation,the perioperative conditions,wrist mobility,wrist function and complications between the two groups were compared.Results:The intraoperative bleeding volume and the time of hospitalization and fracture healing time in group B were significantly lower than those in group A,the operation time in group B was significantly longer than that in group A,the difference was statistically significant(P<0.05).The flexion,extension,pronation,supination,radial deviation and ulnar deviation of wrist joint and the excellent and good rate of wrist function in group B were significantly higher than those in group A at 6 months after operation,the difference was statistically significant(P<0.05),there was no significant difference between group A and group B in wrist flexion,extension,pronation,supination,radial deviation and ulnar deviation of wrist joint and the excellent and good rate of wrist function at 12 months after operation(P>0.05).The incidence of complications in group B was significantly lower than that in group A,the difference was statistically significant(P<0.05).Conclusion:Arthroscopic assisted internal fixation can effectively reduce the surgical trauma and complications of patients with DRF,it’s helpful to promote the postoperative rehabilitation of patients,and it can effectively improve the recent wrist movement and wrist function of patients,it’s worth for further clinical promotion.