两种入路进行掌侧钢板内固定治疗桡骨远端骨折疗效比较

目的比较两种入路掌侧钢板内固定治疗桡骨远端骨折的临床疗效。方法回顾性分析2012年3月—2015年6月江苏省沭阳县人民医院诊治的60例桡骨远端骨折患者,根据手术入路不同分为对照组和观察组。对照组29例采用Henry入路切开旋前方肌进行掌侧钢板内固定治疗,观察组31例采用外侧入路切开旋前方肌与肱桡肌之间的筋膜进行掌侧钢板内固定治疗。比较两组的手术时间、术中出血量、术后住院时间、骨折愈合时间及腕关节活动度。结果两组患者均获12~18个月随访,平均13.5个月。观察组患者手术时间、术中出血量、术后住院时间及骨折愈合时间均少于对照组(P0.05)。末次随访时两组腕关节活动度(背伸度、掌屈度、桡偏度、尺偏度、旋后度、旋前度)及Gartland-Werley评分相比,差异有统计学意义(P0.05)。两组疗效比较,观察组优良率96.8%,较对照组优良率89.7%,差异有统计学意义(P0.05)。结论采用外侧入路行掌侧钢板内固定治疗桡骨远端骨折可以有效保护旋前方肌的功能,具有手术风险小、手术时间短、术中出血量少等优点,临床疗效满意。

Comparison of clinical effect of volar plate fixation by two approaches in treatment of distal radius fractures

Objective To compare the clinical effect of volar plate fixation by two approaches in the treat-ment of distal radius fractures.Methods Totally 60 cases of distal radius fractures were divided into two groups. The control group(29 patients)was treated using the Henry approach,and the observation group(31 patients)was treated by lateral approach.The operation time,blood loss during operation,hospital stay,fracture healing time and the range of motion in wrist joints after treatment between two groups were compared.Results Two groups of pa-tients were followed up for 12-18 months.The operation time,intraoperative bleeding volume,hospitalization stay time and fracture healing time in the observation group were less than those in the control group(P<0.05).Wrist motion (dorsiflexion,flexion,radial and ulnar deviation,supination pronation degree)and Gartland-Werley comparison at the last follow-up were statistically significant(P<0.05).The excellent rate in the observation group was higher than that in the control group(P<0.05).Conclusion The treatment for distal radius fractures by lateral approach can effec-tively protect the function of the anterior circular muscle.It has the advantages of small operation risk,short operation time and less blood loss.