改良Henry入路治疗不稳定桡骨远端骨折的应用效果探讨

Application of modified Henry approach in the treatment of unstable distal radius fractures

目的探讨改良Henry入路治疗不稳定桡骨远端骨折的临床效果及应用价值。方法28例不稳定桡骨远端骨折患者作为研究对象,按照手术方式不同分为A组和B组,每组14例。A组患者采用改良Henry入路掌侧锁定钢板内固定治疗,B组患者则采用传统Henry入路掌侧锁定钢板内固定治疗。比较两组患者手术相关指标、术后并发症发生情况、腕关节功能恢复情况。结果A组患者的手术时间(52.1±5.5)min短于B组的(74.9±8.2)min,术中出血量(20.1±2.2)ml少于B组的(47.8±4.5)ml,且旋前方肌修复率0和正中神经刺激率14.29%均显著低于B组的64.29%、50.00%,差异具有统计学意义(P<0.05)。A组和B组患者术后并发症发生率分别为14.29%(2/14)和50.00%(7/14),A组术后并发症发生率显著低于B组,差异具有统计学意义(P<0.05)。A组和B组患者术后3个月的腕关节恢复优良率分别为100.00%和92.86%,A组略高于B组,但差异无统计学意义(P>0.05)。结论改良Henry入路治疗不稳定桡骨远端骨折对旋前方肌损伤更小,对中正神经的刺激更低,可以大大减少患者的术中出血量,缩短手术时间,且术后并发症发生率低,腕关节功能恢复好,值得推广应用。

Objective To discuss the clinical effect and application value of modified Henry approach in the treatment of unstable distal radius fractures.Methods A total of 28 patients with unstable distal radius fractures as the research subjects were divided into group A and group B according to different surgical methods,with 14 cases in each group.Patients in group A received volar locking plate internal fixation by modified Henry approach,and patients in group B received volar locking plate internal fixation by traditional Henry approach.The surgical related indicators,postoperative complications,and wrist function recovery were compared between the two groups.Results The operation time(52.1±5.5)min of group A was shorter than(74.9±8.2)min of group B,the intraoperative blood loss(20.1±2.2)ml was less than(47.8±4.5)ml of group B,and the pronator repair rate 0 and median nerve stimulation rate 14.29%were significantly lower than 64.29%and 50.00%of group B.All the differences were statistically significant(P<0.05).The postoperative complication rates of group A and group B were 14.29%(2/14)and 50.00%(7/14),respectively.The postoperative complication rate of group A was significantly lower than that of group B,and the difference was statistically significant(P<0.05).The excellent and good rates of wrist function recovery of patients in group A and group B were 100.00%and 92.86%at 3 months postoperatively.Although group A was slightly higher than group B,the difference was not statistically significant(P>0.05).Conclusion The modified Henry approach in the treatment of unstable distal radius fractures has less damage to pronator muscle and less stimulation to median nerve,which can greatly reduce the amount of intraoperative blood loss,shorten the operation time,lower the postoperative complication rates,and has better recovery of wrist joint function.It is worthy of popularization and application.