旋前方肌缝合与否对桡骨远端骨折固定的影响

目的比较旋前方肌的缝合与否对桡骨远端骨折内固定疗效的中期影响。方法两组独立手术医师组，A组对桡骨远端骨折采用切开复位钢板内固定后，不予以缝合旋前方肌；B组对桡骨远端骨折钢板内固定后，仔细修补缝合旋前方肌；共随机回顾性选取30例患者，15例为一组，均为AOB型骨折。分别在术后4周、6个月比较健侧与患侧的腕关节旋前、旋后功能以及上肢功能评分（disabilityofarm—shoulder—hand，DASH）。结果术后4周，患侧的旋前旋后功能较健侧有极显著性差异（P〈0．01）；AB两组患侧组内旋前有显著性差异（P〈0．05），旋后无显著性差异（P〉0．05）；术后6个月，患侧的旋前旋后功能较健侧无显著性差异（P〉0．05）；AB两组患侧组内旋前以及旋后均无显著性差异（P〉0．05）；术后4周，AB两组组间DASH评分具有显著性差异（P〈0．05）；术后6个月，AB两组组间DASH评分无明显差异（P〉0．05）。结论旋前方肌对桡骨远端骨折切开复位内固定的中期疗效无明显影响，手术内固定对桡骨远端B型骨折可取得良好的中期疗效。

Middle-term Clinical Effect of Pronator Quadratus after Volar Plate of A Distal Radius Fracture

Objective To evaluate the midterm clinical effect of pronator quadratus （PQ） repairation after volar plate fixation of a distal radius fracture. Methods Thirty patients of distal radius fractures were radomized to PQ dis- sected group（group A） or to PQ repaired group（group B）. AO classifaction was type B. There were fifteen fractues in each group. DASH score and pronation and supination degree were compared 4 weeks and 6 months after operation. Results After 4 weeks,both pronation and supination function of wrist was significant worse than the normal side （ P 〈 0. 0 1 ）. Pronation in group A was worse than group B （ P % 0. 0 5 ） , DASH score was worse than group B （ P 0.05） ,but supination was not significant difference（P~0.05）. After 6 months ,neither pronation nor supination was function of wrist significant worse than the normal side（P= 〉0.05）. Pronation or supination was not significant different（P〈0.05）and DASH score was not significant difference（P〉0.05） between group A and group B. Conclusion For distal fractures of AO type B,volar palte fixation can achieve a good clinical effct. In the middle-term,pronator quadratus（PQ） dessection or not after volar plate of a distal radius has minimal clinical impact on forearm pronation ruction.