掌侧锁定钢板内固定术在桡骨远端骨折患者中的应用效果

Application effect of volar locking plate internal fixation on wrist joint function in patients with distal radius fracture

目的探讨掌侧锁定钢板内固定术在桡骨远端骨折患者中的应用效果。方法选取2019年9月至2020年8月沈阳医学院附属中心医院收治的84例桡骨远端骨折患者为研究对象,采用摸球方法将其分为对照组和观察组,各42例。对照组采用背侧入路手术,观察组采用掌侧锁定钢板内固定术,比较两组治疗后桡骨恢复情况、疼痛程度、腕关节功能、围手术期指标及生活质量。结果观察组治疗后桡骨高度、掌倾角及尺偏角大于对照组,差异有统计学意义(P<0.05)观察组术后握力、腕关节活动度均高于对照组,差异有统计学意义(P<0.05)。观察组术后1、2周及1个月视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。对照组术后1、2周、1个月VAS评分比较,差异有统计学意义(P<0.05);对照组术后2周VAS评分低于术后1周,差异有统计学意义(P<0.05);对照组术后1个月VAS评分低于术后1、2周,差异有统计学意义(P<0.05);观察组术后1、2周、1个月VAS评分比较,差异有统计学意义(P<0.05);观察组术后2周VAS评分低于术后1周,差异有统计学意义(P<0.05);观察组术后1个月VAS评分低于术后1、2周,差异有统计学意义(P<0.05)。观察组手术、住院及愈合时间均短于对照组,差异有统计学意义(P<0.05);观察组术中出血量少于对照组,差异有统计学意义(P<0.05)。结论锁定钢板内固定术治疗桡骨远端骨折患者中,掌侧入路手术能够有效改善患者骨折复位情况,增加掌倾角、尺偏角,同时改善患者腕关节功能,减少疼痛程度、手术时间及术中出血量,疗效显著,值得推广。

Objective To investigate the application effect of palm locking plate fixation in distal radial fracture.Methods A total of 84 patients with distal radial fracture treated in Central Hospital of Shenyang Medical College from September 2019 to August 2020 were selected as the study subjects and divided into control group and observation group by random touching ball method,with 42 cases each.The control group used dorsal approach surgery,and the observation group used internal fixation of palm locking steel plate.the radial recovery,pain degree,wrist function,perioperative indicators and quality of life were compared between the two groups.Results The radial height,palm inclination angle and ultar deviation angle were bigger than those in the control group(P<0.05).Postoperative observation groups,grip force and wrist activity were higher than those in control groups,and the differences were statistically significant(P<0.05).The VAS score of the observation group at 1,2 weeks and 1 month after operation were lower than those of the control group,the differences were statistically significant(P<0.05).The VAS score of the control group after 1,2 weeks and 1 month were compared,the differences were statistically significant(P<0.05).The VAS score of the control group at 2 weeks after the operation was lower than that at 1 week after operation,and the difference was statistically significant(P<0.05).The VAS score of the control group at 1 month after operation was lower than that at 1 weeks and 2 weeks after operation,the difference was statistically significant(P<0.05).The VAS score of the observation group after 1,2 weeks and 1 month were compared,the differences were statistically significant(P<0.05).The VAS score of the observation group at 2 weeks after the operation was lower than that of 1 week after operation,the difference was statistically significant(P<0.05);the VAS score of the observation group at 1 month after the operation was lower than that at 1,2 weeks after operation,and the differences were statistically significant(P<0.05).The operation time,hospitalization time and healing time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05);the bleeding volume of the observation group was less than that of the control group,the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with distal radius fractures with locking plate internal fixation,volar approach surgery can effectively improve the fracture reduction of the patients,increase the palmar and ulnar deflection angles,improve the wrist joint function of the patients,reduce the degree of pain,the operation time and blood loss.The effect is remarkable and it is worthy of promotion.