桡骨远端AO-C型骨折应用掌侧入路与背侧入路手术治疗的疗效及对患者腕关节功能恢复、并发症的影响

The efficacy of volar approach surgery and dorsal approach surgery for distal radius AO-C fractures and its effects on wrist function recovery and complications

目的探讨桡骨远端AO-C型骨折应用掌侧入路与背侧入路手术治疗的疗效及对患者腕关节功能恢复、并发症的影响。方法我院收治的80例桡骨远端AO-C型骨折患者,根据手术入路部位不同分为掌侧组(应用掌侧入路法进行手术)和背侧组(应用背侧入路法进行手术)各40例,比较两组手术和治疗情况、愈合时间、腕功能评分和并发症情况。结果掌侧组手术时间、愈合时间短于背侧组(P<0.05);两组手术出血量、住院时间和指端血液循环恢复良好时间比较,差异无统计学意义(P>0.05);术后15个月,两组掌屈、背伸、旋前和旋后四项腕关节活动度指标比较,差异无统计学意义(P>0.05),两组DASH-Chinese上肢功能评分(DASH评分)均降低(P<0.05),但组间比较差异无统计学意义(P>0.05);两组治疗总有效率、并发症发生率比较,差异无统计学意义(P>0.05)。结论掌侧入路和背侧入路两种手术方法对桡骨远端AO-C型骨折患者均具有良好疗效,患者术后腕关节功能得到恢复,且并发症的发生率较低,但掌侧入路手术所需时间更短,愈合更快。

Objective To explore the efficacy of volar approach surgery and dorsal approach surgery in the treatment of distal radius AO-C fractures and its effects on wrist function recovery and complications.Methods Eighty patients with distal radius AO-C fractures who were admitted to our hospital were retrospectively analyzed.According to the different surgical approach sites,the patients were divided into volar group(n=40 with volar approach surgery)and dorsal group(n=40 with dorsal approach surgery).The operation and treatment,healing time,wrist function score and complications were compared between the two groups.Results The operative time and healing time in the volar group were shorter than those in the dorsal group(P<0.05).There were no obvious differences in the surgical bleeding volume,hospital stay and time to restore good blood circulation at the fingertips between the two groups(P>0.05).After 15 months of operation,there were no significant differences in the four indexes of wrist joint range of motion of palmar flexion,dorsiflexion,pronation and supination between the two groups(P>0.05).The DASH-Chinese upper limb function(DASH)score in the two groups was significantly decreased(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference in the total effective rate of treatment and the incidence rate of complications between the two groups(P>0.05).Conclusion Both volar approach surgery and dorsal approach surgery have good efficacy for patients with distal radius AO-C fractures.The two methods restore postoperative wrist function and have low incidence rate of complications.However,volar approach surgery has shorter time required for surgery and has faster healing.