改良Henry入路保留旋前方肌掌侧钢板内固定对老年桡骨远端骨折患者DASH评分的影响

The Effect of Modified Henry’s Approach on DASH Score in Elderly Patients with Distal Radius Fractures

目的 探究老年桡骨远端骨折患者应用改良Henry入路保留旋前方肌掌侧钢板内固定的应用效果。方法选取该院2020年8月—2021年7月期间收治的96例老年桡骨远端骨折患者为研究对象,将其随机分为两组,各48例。参照组患者接受常规Henry入路钢板内固定术治疗,研究组患者接受改良Henry入路保留旋前方肌掌侧钢板内固定术治疗,对比两组患者围术期相关指标、预后情况、疼痛评分以及DASH评分。结果 研究组患者手术时间以及骨折暴露时间(58.40±6.89)、(19.75±3.35)min相较于参照组患者(73.16±7.15)、(46.30±6.54)min更短,且术中出血量(14.37±2.35)mL相较于参照组(25.36±3.81)mL更少,差异有统计学意义(t=10.299、25.033、17.009,P<0.001);治疗后6周,研究组患者腕关节屈伸范围、前臂旋转范围以及握力均显著优于参照组患者,VAS、DASH评分相较于参照组患者更低,差异有统计学意义(P<0.05)。结论 改良Henry入路保留旋前方肌掌侧钢板内固定术应用于老年桡骨远端骨折患者中,能取得较为显著的效果。患者治疗周期更短且术中出血量明显下降,经治疗后患者的腕关节、前臂活动情况更佳,且疼痛以及上肢功能均得到显著改善,恢复周期也更短,值得将该术式进行临床推广应用。

Objective To investigate the application effect of the modified Henry’s approach to preserve the volar plate of the pronator muscle in elderly patients with distal radius fractures.MethodsA total of 96 elderly patients with distal radius fractures admitted to the hospital from August 2020 to July 2021 were selected as the research object and randomly divided into two groups,with 48 patients in each group.The patients in the reference group received conventional Henry’s approach with plate fixation,while the study group received the modified Henry’s approach with preservation of the volar pronator muscle.The perioperative related indicators,prognosis,pain score and DASH score were compared between the two groups.ResultsThe operation time and fracture exposure time of the patients in the study group were(58.40±6.89) min and(19.75±3.35) min,compared with the reference group patients(73.16±7.15) min,(46.30±6.54) min were shorter,and the intraoperative blood loss was(14.37±2.35) mL,compared with the reference group(25.36±3.81) mL were less,and the difference was statistically significant(t=10.299,25.033,17.009,P<0.001).At the same time,after 6 weeks of treatment,the wrist flexion and extension range,forearm rotation range and grip strength of the study group were significantly better than those of the reference group,the VAS and DASH scores were lower than those of the reference group,and the difference was statistically significant(P<0.05).ConclusionModified Henry’s approach with palmar plate fixation with preservation of the anterior pronator muscle in elderly patients with distal radius fractures can achieve significant results.The patient’s treatment cycle was shorter and the intraoperative blood loss was significantly reduced.After treatment,the patient’s wrist and forearm activities were better.In addition,the pain and upper limb function have been significantly improved,and the recovery period is also shorter,which is worthy of clinical application.