保留旋前方肌内固定术治疗桡骨远端不稳定性骨折的效果及对术后功能恢复的影响  

Effect of Internal Fixation with Preservation of Pronator Pronator in the Treatment of Unstable Distal Radius Fractures and Its Influence on Postoperative Functional Recovery

作　　者：高兆峰 王海林 房新民 李伟鹏 GAO Zhao-feng;WANG Hai-lin;FANG Xin-min;LI Wei-peng(Department of Hand and Foot Surgery,the Second People's Hospital of Binzhou,Binzhou,Shandong 256651,China)

机构地区：[1]滨州市第二人民医院手足外科,山东滨州256651

出　　处：《临床误诊误治》2020年第12期74-78,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨保留旋前方肌内固定术治疗桡骨远端不稳定性骨折的效果及对术后功能恢复的影响。方法选取我院2018年2月—2019年10月收治的93例桡骨远端不稳定性骨折患者,据手术方法的不同分为观察组49例和对照组44例。观察组予不切开旋前方肌的掌侧入路钢板内固定术,对照组予切开旋前方肌的掌侧入路钢板内固定术。比较术后6个月两组临床疗效,手术时间、术中出血量、骨折愈合时间,术前及术后6个月患腕关节旋前、旋后、桡偏、尺偏活动度,以及术后6个月并发症发生情况。结果治疗后观察组优良率为95.92%高于对照组的79.55%(χ^2=5.959,P=0.015)。观察组手术时间、骨折愈合时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05或P<0.01)。术后6个月,两组腕关节旋前、旋后、桡偏、尺偏角度均较术前改善,且观察组改善程度远大于对照组,差异有统计学意义(P<0.05或P<0.01)。观察组术后6个月手术并发症发生率为8.16%低于对照组的27.27%(χ^2=5.943,P=0.015)。结论采用保留旋前方肌内固定术治疗桡骨远端不稳定性骨折可显著提高临床效果,缩短手术时间、骨折愈合时间,减少术中出血量,改善患腕关节活动度,且术后并发症发生率低。Objective To investigate the effect of internal fixation with preservation of pronator pronator muscle in the treatment of unstable distal radius fractures and its influence on postoperative functional recovery.Methods A total of 93 cases of unstable distal radius fractures treated in our hospital from February 2018 to October 2019 were retrospectively analyzed.According to the different surgical methods,they were divided into observation group(n=49)and control group(n=44).The observation group received plate internal fixation via volar approach without pronator muscle incision,and the control group received plate internal fixation via volar approach with pronator muscle incision.The patients in the control group were treated with locking volar internal rotation plate.Six months after the operation,the clinical efficacy,duration of operation,intraoperative blood loss,fracture healing time,as well as pronation,supination,radial deviation,and ulnar deviation and the incidence of surgical complications of the two groups before and at 6 month after operation were compared.Results After treatment,the excellent and good rate of the observation group was 95.92%,which was higher than 79.55%of the control group(χ^2=5.959,P=0.015).The duration of operation and fracture healing time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05 or P<0.01).At 6 months after operation,the pronation,supination,radial deviation and ulnar deviation angle of the two groups were improved compared with those before operation,and the improvement degree of the observation group was much greater than that of the control group(P<0.05 or P<0.01).The incidence of surgical complications at 6 months after operation in the observation group was 8.16%,which was lower than 27.27%in the control group(χ^2=5.943,P=0.015).Conclusion The treatment of unstable distal radius fractures with internal fixation by preserving pronator muscle can significantly improv

关 键 词：桡骨骨折 骨折固定术 内 旋前方肌 手术时间 关节活动度 手术后并发症 

分 类 号：R683.41[医药卫生—骨科学]