腕背伸肌支持带筋膜瓣在桡骨远端骨折背侧入路中的应用  

Application of back of wrist extensor retinaculum fascial flap in the treatment of distal radius fractures

作　　者：谭俊峰[1] 刘洋[1] 李明辉[1] 杨青[1] TAN Junfeng;LIU Yang;LI Minghui;YANG Qing(Department of Orthopaedics, Wuhan Fifth Hospital, the Second Hospital Affiliated to Jianghan University, Wuhan 430050, China)

机构地区：[1]武汉市第五医院(江汉大学第二附属医院)骨科,武汉430050

出　　处：《骨科》2017年第1期48-51,共4页ORTHOPAEDICS

摘　　要：目的探讨腕背伸肌支持带筋膜瓣在桡骨远端骨折背侧入路中的临床应用。方法选择2010年6月至2015年6月我院收治的桡骨远端骨折需行背侧入路固定病人120例。按照就诊的先后顺序采用数字表法将病人随机分为两组,筋膜瓣组52例病人骨折复位固定后采用腕背伸肌支持带筋膜瓣对拇长伸肌腱进行转位,常规手术组68例病人仅采用常规骨折复位固定手术。术后随访观察并比较两组病人拇长伸肌腱并发症的发生率。结果本组120例病人均手术成功,均获得随访,随访时间为3~60个月(平均为16.2个月)。筋膜瓣组未出现肌腱并发症;常规手术组发生3例拇长伸肌腱炎,1例拇长伸肌腱断裂,肌腱并发症发生率为5.88%。筋膜瓣组的肌腱并发症发生率明显低于常规手术组,差异有统计学意义(P=0.075)。结论与掌侧入路钢板置入治疗桡骨远端骨折相比,背侧入路钢板置入固定后的肌腱并发症发生率较高,腕背伸肌支持带筋膜瓣可以很好地避免这一并发症,并且操作简单,值得推广使用。Objective To explore the application of back of wrist extensor retinaculum fascial flap in the treatment of distal radius fractures. Methods Total of 120 patients with distal radius fractures were treated with dorsal plate fixations from June 2010 to June 2015. All of the120 patients were divided into two groups ran?domly according to the time of present. Fifty?two cases were treated with back of wrist extensor retinaculumfascial flap, and the rest 68 cases were treated with the conventional operation. The incidence of the com?plications of tendon stimulus in the two groups was observed. Results All surgical operations were performedsuccessfully on 120 cases. The patients obtained a follow?up of 3?60 months. There were no complications oftendon stimulus syndromes and rupture of tendons in the fascial flap group. Tendonitis occurred in 3 cases andtendon rupture in one case in the conventional surgery group. The incidence of the complications of tendonstimulus in the fascial flap group was 0%, and 5.88% in the conventional surgery group. There was significant difference in the incidence of complications of tendon stimulus between two groups (P=0.075). Conclusion Compared with volar plate fixation, a high risk of tendon irritation was found after dorsal fixation. Back of wrist extensor retinaculum fascial flap can be very good to avoid the complications, and it is worthy of promotion of use.

关 键 词：筋膜瓣 桡骨远端骨折 手术入路 骨折固定术 内 伸肌支持带 

分 类 号：R687.3[医药卫生—骨科学]