不同旋前方肌处理方案对桡骨远端骨折内固定术的影响

目的：探讨切开与不切开旋前方肌对桡骨远端骨折内固定术患者的影响。方法选取2013年1月至2015年2月南宁市横县人民医院骨科收治的桡骨远端骨折患者86例，按照对旋前方肌的处理方案分为切开组42例和不切开组44例。比较两组患者的手术情况、愈合情况，以及术后3个月和6个月腕关节功能的恢复情况。结果不切开组患者愈合优良率为97.73%，切开组为92.86%，差异无统计学意义(P>0.05)；不切开组患者的手术时间和术中出血量分别为(88.6±16.1) min和(15.3±3.4) mL，切开组分别为(70.3±10.2) min和(20.1±4.8) mL，差异均有统计学意义(P<0.05)；不切开组患者负重时间和骨折愈合时间分别为(36.3±5.2) d和(36.8±4.1) d，切开组分别为(45.2±7.1) d和(47.9±5.2) d，差异均有统计学意义(P<0.05)；不切开组术后3个月腕关节功能恢复优良率为84.09%，切开组为73.81%，差异有统计学意义(P<0.05)；不切开组术后6个月腕关节功能恢复优良率为95.45%，切开组为90.48%，差异无统计学意义(P>0.05)。结论不切开旋前方肌可减少屈肌腱损伤，减少术中出血量，缩短负重锻炼时间和骨折愈合时间，能更早恢复腕关节功能。

Effect of different rotary anterior muscle treatment on internal fixation of distal radius fracture

Objective To investigate the effect of incision and non-internal fixation incision on the anterior muscle of the patients with distal radius fracture. Methods A total of 86 patients with distal radius fractures, who admit-ted to Department of Orthopedics of the People's Hospital of Hengxian County from January 2013 to February 2015, were selected and divided into the incision group (n=42) and the non-incision group (n=44) according to the treatment scheme of the anterior muscle of the spiral. The operation, healing and recovery of wrist function of 3 months and 6 months after operation were compared between the two groups. Results There was no significant different between the incision group and the non-incision group in the excellent rate (97.73%, 92.86%, respectively), P>0.05. There were sig-nificant differences between the incision group and the non-incision group in the operative time and blood loss, (88.6 ± 16.1) min vs (70.3±10.2) min, (15.3±3.4) mL vs (20.1±4.8) mL, respectively (P<0.05). There were also significant differenc-es between the incision group and the non-incision group in the load time and healing time of fracture, excellent recovery rate of wrist joint function after 3 months, (36.3±5.2) d vs (45.2±7.1) d, (36.8±4.1) d vs (47.9±5.2) d, 84.09%vs 73.81%, re-spectively (P<0.05), but there was no significant difference between the incision group and the non-incision group in ex-cellent recovery rate of wrist joint function after 6 months (95.45%vs 90.48%), P>0.05. Conclusion Non-incision on the anterior muscle of the patients with distal radius fracture can reduce flexor tendon injury and blood loss, shorten the time of weight bearing exercise and fracture healing, and restore the function of wrist joint earlier.