掌侧正中微创入路锁定钢板对桡骨远端骨折患者腕关节功能及主动活动度的影响  

Effect of locking plate via palmar median minimally invasive approach on wrist function and active range of motion in patients with distal radius fractures

作　　者：徐鹏 强晓军[1] XU Peng;QIANG Xiaojun(The First Department of Orthopedics,Puyang Oilfield General Hospital,Puyang 457001,Henan,China)

机构地区：[1]濮阳市油田总医院骨一科,河南省濮阳市457001

出　　处：《微创医学》2020年第3期301-303,320,共4页Journal of Minimally Invasive Medicine

摘　　要：目的研究掌侧正中微创入路锁定钢板内固定治疗对桡骨远端骨折患者腕关节旋后活动度的影响。方法选择58例桡骨远端骨折患者作为观察对象,按照随机双盲法分为常规入路组和微创入路组,各29例。微创入路组患者实施掌侧正中微创入路锁定钢板内固定治疗,而常规入路组实施常规入路锁定钢板内固定治疗。对比两组患者的手术指标、腕关节主动活动度、腕关节功能和桡骨远端解剖学参数。结果微创入路组切口长度明显短于常规入路组,腕关节掌屈、背伸、旋前、旋后、尺偏和桡偏度均明显大于常规入路组,腕关节功能优于常规入路组(均P<0.05)。两组患者手术时间、术中出血量,以及术后桡骨高度、尺偏角和掌倾角等桡骨远端解剖学参数比较,差异无统计学意义(均P>0.05)。结论在掌侧正中锁定钢板内固定治疗中实施微创入路的桡骨远端骨折患者,早期腕关节功能恢复较快,腕关节主动活动度改善良好,康复时间明显缩短。Objective To study the effect of locking plate via palmar median minimally invasive approach on wrist function and active range of motion in patients with distal radius fractures. Methods Fifty-eight patients with distal radius fractures were selected as observation subjects and divided into conventional and minimally invasive approach groups according to the randomized double-blind method, with 29 cases in each group. The patients in the minimally invasive approach group were treated with locking plate internal fixation via palmar median minimally invasive approach, while those in the conventional approach group were treated with locking plate internal fixation via a conventional approach. The operation indexes, active range of motion, function of the wrist, and anatomical parameters of the distal radius were compared between the two groups. Results The minimally invasive approach group had a shorter incision length, larger range of metacarpal flexion, dorsiflexion, pronation, supination, ulnar deviation, and radial deviation of the wrist joint, and a better wrist function as compared to the conventional approach group(all P<0.05). There were no significant differences in operation time, intraoperative bleeding volume, as well as postoperative anatomical parameters of the distal radius in radial height, and the ankle of ulnar deviation and palmar between the two groups(all P>0.05). Conclusion Patients with distal radius fractures undergoing palmar median locking plate internal fixation treatment via minimally invasive approach have faster recovery of the wrist joint function, a better wrist joint active range of motion, and shorter recovery time.

关 键 词：掌侧正中锁定钢板 桡骨远端骨折 微创入路 腕关节功能 主动活动度 

分 类 号：R683.41[医药卫生—骨科学]