经桡侧腕屈肌腱入路DVR钢板内固定治疗桡骨远端骨折的疗效观察  

Clinical observation of DVR steel plate internal fixation through flexor carpi radialis tendon approach in the treatment of distal radius fractures

作　　者：白志强 刘灿 聂庆虎 蒋协远[2] Bai Zhiqiang;Liu Can;Nie Qinghu;Jiang Xieyuan(Department of Orthopedics,Beijing First Integrated Hospital of Chinese and Western Medicine,Beijing 100026,China;Department of Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京市第一中西医结合医院骨科,北京100026 [2]北京积水潭医院骨科,北京100035

出　　处：《中国医刊》2021年第10期1094-1097,共4页Chinese Journal of Medicine

摘　　要：目的探讨经桡侧腕屈肌腱(flexor carpi radialis tendon,FCRT)入路行桡骨远端骨折切开复位DVR钢板内固定的治疗效果。方法回顾性分析2014年1月至2019年12月在北京市第一中西医结合医院行掌侧入路切开复位DVR钢板内固定治疗的127例桡骨远端骨折患者,其中经FCRT入路69例(研究组),桡骨远端Henry入路58例(对照组)。比较两组的骨折显露时间、手术时间、术中出血量、正中神经损伤发生率、桡动静脉及其分支损伤发生率,术后12个月时的桡骨茎突高度、尺偏角、掌倾角、腕关节功能患者自评量表(patient rated wrist evaluation,PRWE)评分及Gartland-Werley评分情况。结果127例患者均获随访,随访时间12~24个月,平均15.5个月。研究组骨折显露时间、手术时间短于对照组,术中出血量少于对照组,桡动静脉及其分支损伤发生率低于对照组,差异有显著性(P<0.05)。两组术后正中神经损伤发生率比较差异无显著性(P>0.05)。术后12个月时两组桡骨茎突高度、尺偏角、掌倾角、腕关节功能PRWE评分及Gartland-Werley评分比较差异均无显著性(P>0.05)。结论经FCRT入路DVR钢板内固定治疗桡骨远端骨折术中无需解剖显露桡动静脉血管,骨折显露时间及手术时间均较短,术中出血量较少,桡动静脉及其分支损伤发生率较低,值得临床应用。Objective To investigate the effect of open reduction and DVR steel plate internal fixation of distal radius fractures through flexor carpi radialis tendon(FCRT)approach.Method 127 cases of distal radius fractures treated by volar approach open reduction and DVR steel plate internal fixation in our hospital from January 2014 to December 2019 were retrospectively analyzed,including 69 cases by FCRT approach(group A)and 58 cases by Henry approach(group B).The exposure time,operation time,blood loss,median nerve injury rate,radial artery and vein and its branches injury rate,and radial styloid process height,ulnar deviation angle,palmar inclination angle and Gartland-werley score of wrist function at 12 months after operation were compared between the two groups.Result 127 cases were followed up for 12-24 months(average 15.5 months).The exposure time and operation time of group A were shorter than those of group B,and the blood loss of group A was less than that of group B,the difference was statistically significant(P<0.05).There was no significant difference in the height of radial styloid process,ulnar deviation angle,palmar inclination angle,Gartland-werley score and PRWE(patient rated twist evaluation)score between the two groups 12 months after operation(P>0.05).The incidence of radial artery and vein and its branches injury in group A was lower than that in group B(P<0.05).Conclusion In the treatment of distal radius fractures with DVR plate fixation via FCRT approach,there is no need to expose the radial artery and vein during the operation.The exposure time and operation time of the fractures are shorter,and the amount of bleeding is less.The incidence of radial artery and vein and its branches injury and median nerve injury are lower.

关 键 词：桡骨远端骨折 桡侧腕屈肌腱入路 Henry入路 DVR钢板 内固定 

分 类 号：R683.41[医药卫生—骨科学]