加强缝合保留旋前方肌锁定接骨板治疗桡骨远端不稳定骨折的临床疗效

Clinical effecton retaining and strengthening the locking plate of anterior rotator muscle in the treatment of unstable fractures of distal radius

目的研究加强缝合旋前方肌,在掌侧入路锁定接骨板治疗桡骨远端不稳定骨折中的临床疗效及价值。方法纳入2016年3月至2019年3月在乌鲁木齐市中医医院骨科手术治疗的桡骨远端不稳定骨折患者12例,手术均选择掌侧Henry入路,术中保留并加强缝合旋前方肌后再行锁定接骨板的置入。12例患者,其中男性2例,女性10例;年龄47~76岁,平均61岁。按照AO/OTA分型:A3型4例,B2型2例,C2型5例,C3型1例。结果术后患者进行6个月的随访,末次随访时,骨折均愈合。无术后感染、内固定失败及骨折不愈合等并发症发生。根据Gartland-Werley腕关节功能评分结果:优8例,良4例。结论在掌侧入路锁定接骨板治疗桡骨远端不稳定骨折治疗中,通过加强缝合旋前方肌能有效保留旋前方肌的结构及功能,减少手术创伤,减轻术后肢体肿胀,可尽早功能锻炼,符合微创理念,适合临床推广。

Objective To investigate the clinical efficacy of metacarpal approach in the treatment of unstable fractures of the distal radius by retaining and strengthening the suture of anterior rotator muscle and locking bone plate.Methods Twelve patients with unstable fractures atthe distal radius treated in our department from March 2016 to March 2019 were included in this study.The Henry approach was selected for all surgeries,and the anterior rotator muscle was preserved and strengthened during the surgery,followed by the placement of the locking plate.Among the 12 patients,2 caseswere male and 10 cases were female.The ages ranged from 47 to 76 years old,with an average age of 61 years old.According to AO/OTA classification,4 cases were divided into A3 type,2 cases were B2 type,5 cases belonged to C2 type,and 1 case was C3 type.Results All patients were followed up for 6 months after the operation,and all fractures healed at the last follow up.No postoperative infection,internal fixation failure,fracture nonunion and other complications occurred.According to gartland-Werley wrist function score,there were 8 excellent cases and 4 good cases.Conclusions The treatment of unstable fractures of the distal radius bythe metacarpal approach retaining and strengthening the suture of anterior rotator muscle and locking bone plate can effectively retain the structure and function of anterior rotator muscle,reduce surgical trauma,reduce postoperative limb swelling,and conduct functional exercise as soon as possible,which is accorded with the concept of minimally invasive therapy and suitable for clinical promotion.