桡骨远端骨折掌侧钢板螺钉内固定术中保留旋前方肌对疗效的影响  

Effect of preserving pronator quadratus in volar plate internal fixation for distal radius fractures

作　　者：白晓冬[1] 许国强 王刚[1] 刘振宇[1] 高化[1] 陈文韬[1] 赵亮[1] 李亚东[1] 王宝军[1] BAI Xiao-dong;XU Guo-qiang;WANG Gang;LIU Zhen-yu;GAO Hua;CHEN Wen-tao;ZHAO Liang;LI Ya-dong;WANG Bao-jun(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院创伤骨科,北京100050

出　　处：《中国骨与关节损伤杂志》2022年第1期24-27,共4页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金(81701203)。

摘　　要：目的探讨桡骨远端骨折掌侧钢板螺钉内固定术中保留旋前方肌对临床疗效的影响。方法回顾性分析自2015-01—2018-11采用掌侧钢板螺钉内固定治疗的90例桡骨远端骨折,45例在术中保留旋前方肌(观察组),45例在术中切开旋前方肌并进行修复(对照组),比较两组术后12个月桡骨茎突高度、掌倾角、尺偏角以及腕关节背伸、掌屈、尺偏、桡偏、旋前、旋后角度,比较两组术后1周、术后1个月疼痛VAS评分及末次随访时的Gartland-Werley评分。结果两组均顺利完成手术,随访时间12~28个月,平均15.6个月。骨折均获得骨性愈合,骨折愈合时间3~4个月,平均3.5个月。术后12个月两组桡骨茎突高度、掌倾角、尺偏角以及腕关节背伸、掌屈、尺偏、桡偏角度比较差异无统计学意义(P>0.05);观察组腕关节旋前、旋后角度较对照组大,差异有统计学意义(P<0.05)。术后1周、术后1个月观察组疼痛VAS评分较对照组低,差异有统计学意义(P<0.05)。末次随访时观察组Gartland-Werley评分较对照组低,差异有统计学意义(P<0.05)。结论掌侧钢板螺钉内固定治疗桡骨远端骨折可以获得满意的临床疗效,术中保留旋前方肌能降低患者术后疼痛、改善关节功能情况。ObjectiveTo investigate the effect of preserving pronator quadratus in volar plate and screw internal fixation for distal radius fracture.MethodsNinety cases of distal radius fractures treated with volar plate internal fixation from January2015 to November 2018 were analyzed retrospectively. The pronator quadratus was preserved during operation in 45 cases(observation group), and was cut and repaired in 45 cases(control group). The radial styloid process height, palmar inclination, ulnar deviation, dorsal extension, palmar flexion, ulnar deviation, radial deviation, pronation and supination angles 12 months after operation were compared between the two groups. The pain VAS scores at 1 week and 1 month follow-up were compared between the two groups, and the Gartland-Werley scores at the last follow-up were compared.ResultsThe operation was successfully completed in both groups. The follow-up time was 12-28 months, with an average of 15.6 months. Bone healing was achieved in all fractures. The fracture healing time was 3-4 months, with an average of 3.5 months. There was no significant difference in radial styloid process height, palmar inclination, ulnar deviation, dorsal extension, palmar flexion, ulnar deviation and radial deviation at 12-month follow-up between the two groups(P>0.05). The pronation and supination angles in the observation group were better than those in the control group(P<0.05). The pain VAS score at 1 week and 1 month follow-up in the observation group was lower than that in the control group(P<0.05). At the last follow-up, the Gartland-Werley score of the observation group was lower than that of the control group(P<0.05).ConclusionThe use of volar plate in the treatment for distal radius fractures can obtain satisfactory clinical results. The preservation of pronator quadratus during the operation can reduce postoperative pain and improve wrist joint function.

关 键 词：桡骨远端骨折 旋前方肌 内固定 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]