经Henry切口于桡骨外侧放置干骺端钢板治疗近端桡骨干骨折的疗效分析

Proximal radial shaft fracture fixated by a metaphyseal plate lateral to the radius through the Henry approach

目的探索采用Henry入路显露并将干骺端接骨板置于桡骨外侧固定治疗近端桡骨干骨折的治疗效果。方法回顾性分析2018年4月至2019年6月间北京积水潭医院采用Henry入路显露并将干骺端钢板置于桡骨外侧固定治疗的5例近端桡骨干骨折(近端桡骨干骨折定义为骨折累及范围位于桡骨粗隆至旋前圆肌止点之间)的患者资料。男2例,女3例;年龄16~59岁,平均41.4岁;左侧3例,右侧2例。术后规律随访和记录患者影像学资料、骨折愈合时间、前臂旋前-旋后活动度以及疼痛视觉模拟评分(VAS)、上肢功能障碍评分(Quick-DASH)、Anderson标椎以及Grace和Eversmann标准评定疗效。结果5例患者术后获7~16个月(平均10.6个月)随访。所有患者骨折愈合时间平均4.6个月。肘关节屈曲平均146°,伸直平均-2°,旋前平均77°,旋后平均88°。术后VAS评分:4例为0分,1例为1分。末次随访时Quick-DASH评分平均4.1分;根据Anderson标准评估疗效:5例均为优;根据Grace和Eversmann标准评估疗效:优4例,良1例。无一例患者发生术后并发症。结论采用Henry切口显露并将干骺端钢板置于桡骨外侧固定是治疗近端桡骨干骨折的有效方法。

Objective To explore the feasibility and therapeutic efficacy of using the Henry approach to expose and place a metaphyseal bone plate laterally to fixate a proximal radial shaft fracture.Methods A retrospective analysis was done of the 5 proximal radial shaft fractures(defined as the fracture involving the extent between the radial tuberosity to the insertion of the pronator teres)which had been treated from April 2018 to June 2019 at Department of Traumatology and Orthopedics,Beijing Jishuitan Hospital through the Henry approach to place a metaphyseal plate laterally to the radius for fixation.There were 2 males and 3 females,aged from 16 to 59 years(average,41.4 years),with 3 cases on the left side and 2 cases on the right side.The imaging data,fracture healing time,forearm pronation-supination,and visual analogue scale(VAS)of the patients were regularly followed up;the therapeutic efficacy was evaluated at the last follow-up using Quick Disabilities of the Arm,Shoulder,and Hand(Quick-DASH),Anderson and Grace-Eversmann evaluations.Results The 5 patients were followed up for 7 to 16 months(average,10.6 months).Their fracture healing time averaged 4.6 months,elbow flexion 146°,extension-2°,pronation 77°,and supination 88°.In postoperative VAS,4 cases scored a 0 point and one case 1 point.At the last follow-up,their Quick-DASH scores averaged 4.1 points;by the Anderson evaluation,5 cases were excellent;by the Grace-Eversmann evaluation,4 cases were excellent and one case was good.No postoperative complication was observed.Conclusion It is an effective treatment of proximal radial shaft fracture to use the Henry approach to expose and place a 3.5mm metaphyseal plate laterally to the radius for fixation.