桡侧腕屈肌腱入路切开复位内固定对桡骨远端骨折患者疼痛介质水平及关节功能的影响

Effect of open reduction and internal fixation via flexor carpi radialis approach on pain mediators and joint function in patients with distal radius fractures

目的探究桡侧腕屈肌腱入路切开复位内固定对桡骨远端骨折患者疼痛介质水平及关节功能的影响。方法选取2020年3月至2021年12月江西省萍乡市第二人民医院收治的80例桡骨远端骨折患者作为研究对象,按照随机数字表法将其分为对照组(40例)与观察组(40例)。对照组患者采取直接掌侧入路切开复位内固定,观察组患者采取桡侧腕屈肌腱入路切开复位内固定。比较两组患者的疼痛介质水平[前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)]、骨折愈合时间、腕关节功能(Gartland-Werley评分)。结果两组患者术后1周的5-HT、PGE_(2)低于本组术前,观察组的5-HT、PGE_(2)低于对照组,差异有统计学意义(P<0.05)。观察组骨折愈合时间短于对照组,差异有统计学意义(P<0.05)。两组患者术后3个月的Gartland-Werley评分低于术前,观察组Gartland-Werley评分低于对照组,差异有统计学意义(P<0.05)。结论桡侧腕屈肌腱入路切开复位内固定可降低桡骨远端骨折患者疼痛介质水平,促进骨折愈合及腕关节功能恢复。

Objective To investigate the effect of open reduction and internal fixation via flexor carpi radialis tendon approach on pain mediator levels and joint function in patients with distal radius fractures.Methods A total of 80 patients with distal radius fracture admitted to the Second People's Hospital of Pingxiang,Jiangxi Province from March 2020 to December 2021 were selected as the research objects.According to the random number table method,they were divided into control group(40 cases)and observation group(40 cases).Patients in the control group were treated with open reduction and internal fixation via direct volar approach,while patients in the observation group were treated with open reduction and internal fixation via flexor carpi radialis tendon approach.The levels of pain mediators(prostaglandin E_(2)[PGE_(2)],5-hydroxyserotonin[5-HT]),fracture healing time,and wrist function(assessed by Gartland-Werley score)were compared between the two groups.Results After surgery,the 5-HT and PGE_(2) of the two groups were lower than those 1 week before surgery,and the 5-HT and PGE_(2) of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The fracture healing time of observation group was shorter than that of control group,and the difference was statistically significant(P<0.05).The Gartland-Werley scores of the two groups at 3 months after operation were lower than those before operation,and the Gartland-Werley score of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Open reduction and internal fixation via flexor carpi radialis approach can reduce the level of pain mediators in patients with distal radius fractures and promote fracture healing and wrist function recovery.