不同入路方式下锁定钢板内固定治疗桡骨远端骨折的效果及对腕关节功能的影响

Effect of Locking Plate Internal Fixation on Distal Radius Fracture with Different Approaches and Its Effect on Wrist Function

目的:分析不同入路方式下锁定钢板内固定治疗桡骨远端骨折的效果及对腕关节功能的影响。方法:选取本院2017年6月-2020年7月收治的78例桡骨远端骨折患者,依不同入路方式分为研究组和对照组,每组39例。研究组用掌侧入路下锁定钢板内固定治疗,对照组用背侧入路下锁定钢板内固定治疗。对两组的治疗效果、并发症、VAS、Barthel、SF-36、Fugl-Myer评分、手术、住院、骨折愈合时间,以及腕关节功能进行对比。结果:两组治疗总有效率比较,差异无统计学意义(P>0.05),研究组VAS评分低于对照组(P<0.05),两组Barthel、SF-36、Fugl-Myer评分比较,差异无统计学意义(P>0.05),研究组并发症发生率低于对照组(P<0.05),手术时间短于对照组(P<0.05),两组住院、骨折愈合时间、腕关节功能比较,差异无统计学意义(P>0.05)。结论:掌侧和背侧两种入路方法治疗效果都较为显著。掌侧入路下锁定钢板内固定治疗,手术时间短,并发症发生率低,安全可靠,并且疼痛较轻,具有临床应用的价值和意义。

Objective:To analyze the effect of locking plate internal fixation on distal radius fracture with different approaches and its effect on wrist function.Method:From June 2017 to July 2020,78 patients with distal radius fractures were selected,according to different approaches,78 cases were divided into the study group and the control group.The study group(n=39)was treated with locking plate fixation under the palmar approach,the control group(n=39)was treated with a dorsal approach,the treatment effect,complications,VAS,Barthel,SF-36,Fugl-Myer score,time of operation,hospitalization,fracture healing,and wrist function in both groups were compared.Result:The treatment effect in two groups was not significantly different(P>0.05),VAS score in the study group was lower than that in the control group(P<0.05),there were no significant differences in Barthel,SF-36,Fugl-Myer scores in two groups(P>0.05),the incidence rate of complications in the study group was lower than that in the control group(P<0.05),the operation time in the study group was shorter than that in the control group(P<0.05),the time of hospitalization,fracture healing and wrist function in two groups were not significantly different(P>0.05).Conclusion:The effect of the palmar approach and dorsal approach is more significant.The locking plate fixation under palmar approach with shorter operation time,and lower incidence rate of complications is safe,reliable,and the pain is mild.It has the value and significance of clinical application.