改良背侧手术切口入路治疗早期桡骨远端陈旧性骨折的疗效

目的探讨改良的背侧手术切口入路在治疗早期(21~35 d)桡骨远端陈旧性骨折的临床效果。方法对36例(40侧)早期桡骨远端陈旧性骨折患者行改良背侧手术切口入路治疗。分析其手术时间、术后复位X线摄片评价、术后并发症、骨折愈合时间及肢体肿胀消肿时间的情况,按Gartland and werley功能评分标准对患者腕关节功能恢复情况进行评价。结果 36例(40侧)患者手术时间为65~90 min,平均75 min。术后复查X-ray骨折端对位、对线,桡骨远端长度及掌倾角恢复良好,骨折端稳定,无切口感染,无桡神经皮支或正中神经损伤及骨筋膜室综合征。患侧肿胀消退时间为术后5~10 d,平均7.3 d;骨折愈合时间为术后2.8~4.3个月,平均3.5个月。所有病例均获3~12个月的随访,按Gartland and werley功能评定,优26侧,良9侧,可3侧,差2侧,优良率为87.5%。结论通过改良背侧手术切口入路对早期桡骨远端陈旧性骨折患者进行手术治疗,能取得满意的效果。

Improved Dorsal Incision Approach for Early Stage of Old Distal Radius Fractures

Objective To investigate the clinical efficacy of the improved dorsal incision approach in the treatment of early stage（21-35 days） of old distal radius fractures. Methods Thirty-six cases （40 sides） of early stage of old distal radius fractures underwent surgery via dorsal incision approach. Operation time,radiographic assessment of postoperative reduction, postoperative complications,fracture healing time and detumescence time were analyzed. In addition,curative efficacy was evaluated using Gartland and Werley Functional Scoring Criteria. Results The average operation time was 75 minutes （range,65 to 90 minutes）. Postoperative X-ray examination showed good fracture contraposition, alignment,distal radial length and volar tilt without incision infection,median nerve injury,cutaneous branch injury of radial nerve and osteofascial compartment syndrome. The average ipsilateral detumescence time was 7.3 days （range,5-10 days）. The average fracture healing time was 3.5 months （range,2.8-4.3 months）. All patients were followed up for 3-12 months. According to Gartland and werley functional scoring criteria, the outcome was excellent in 26 cases,good in 9,fair in 3,and poor in 2. The excellent and good rate was 87.5%. Conclusion The improved dorsal incision approach is effective and satisfactory for the treatment of early stage of old distal radius fractures.