改良Henry入路治疗桡骨远端AO B型骨折的疗效分析  

Clinical analysis of preserving pronator muscle in the treatment of AO B fracture of distal radius

作　　者：黄晓夏 伊尔夏提·克力木 彭聪 孔维奇 买买提艾力·吐孙尼牙孜 马创[1] 赵岩[1] 马超[2] 王新苛 任军 HUANG Xiaoxia;Erxat Kerem;PENG Cong;KONGWeiqi;Maimaitiaili Tusunniyazi;MAChuang;ZHAO Yan;MAChao;WANG Xinke;REN Jun(Department of Orthopaedics,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;Changji Branch of the First Affiliated Hospital of Xinjiang Medical University,Changji 831100,China)

机构地区：[1]新疆医科大学第一附属医院骨科,乌鲁木齐830054 [2]新疆医科大学第一附属医院昌吉分院,昌吉831100

出　　处：《中华骨与关节外科杂志》2022年第1期43-48,共6页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金(81763097)。

摘　　要：目的:探讨改良Henry入路联合掌侧锁定接骨板治疗桡骨远端AO B型骨折的临床效果。方法:采用回顾性病例对照研究分析2019年5月至2020年7月收治的44例桡骨远端AO B型骨折患者。改良Henry入路组22例,男7例,女15例,年龄28~85岁,平均56.0(53.8,62.3)岁;传统Henry入路组22例,男9例,女13例;年龄22~71岁,平均59.0(52.50,64.0)岁。观察两组术后内固定、骨折愈合、并发症等情况。分别采用视觉模拟评分(VAS)、Dienst关节评分标准、影像学指标评估术后腕部疼痛、腕关节功能、手术疗效。结果:两组患者术后随访时间12~16个月,平均(13.0±1.5)个月。所有切口愈合良好,无感染、坏死。两组手术时间、术中出血量、旋前方肌修复率相比,差异有统计学意义(P<0.05)。术后3个月,改良组和传统组腕关节功能优良率分别为95.5%和90.9%,两组比较差异无统计学意义(P>0.05)。两组术后3 d、1个月、3个月的桡骨高度、掌倾角、尺偏角相比,差异均无统计学意义(P>0.05)。术后1周、1个月、3个月改良组VAS评分均低于传统组(P<0.05),而术后12个月两组VAS评分相比,差异无统计学意义(P>0.05)。两组患者术后均未出现创伤性关节炎,改良组发生关节僵硬1例;传统组:屈肌腱激惹、关节僵硬各2例,腕管综合征2例(Ⅱ期取出内固定装置,营养神经治疗后,症状缓解)。结论:对桡骨远端AOB型骨折患者实施改良Henry入路联合掌侧接骨板固定,手术时间短、出血量少、旋前方肌修复率高、并发症少,可减轻术后早期疼痛,值得临床推广应用。Objective: Objective: To investigate the clinical effect of modified Henry approach combined with volar locking plate on AO B fracture of distal radius. Methods: A retrospective case-control study was performed in 44 patients with AO B fracture of distal radius treated from May 2019 to July 2020. In modified Henry approach group, there were 7 males and 15 females with an average age of 56.0(53.8, 62.3) years(range, 28-85 years). In traditional Henry approach group, there were 9 males and 13 females with an average age of 59.0(52.5, 64.0) years(range, 22-71 years). Postoperative internal fixation, fracture healing and complications of the two groups were observed. The wrist pain, wrist function and surgical curative effect were evaluated by visual analogue scale(VAS),Dienst scoring, and imaging, respectively. Results: The mean duration of follow-up was(13.0 ± 1.5) months(range, 12-16 months) in all the patients. All the patients had good incision healing without infection or necrosis. There were statistical differences in operation time, amount of bleeding and repair rate of pronator muscle between the two groups(P<0.05). The excellent and good rate of wrist function was 95.5% in the modified group and 90.9% in the traditional group 3 months after operation(P>0.05).There was no significant difference in the height of the radius, palmar tilting angle or ulnar drifting angle between the two groups on day 3, at 1 and 3 months postoperatively(P>0.05). VAS score of the modified group was significantly lower than that in the traditional group at 1 week, 1 month and 3 months postoperatively(P<0.05), but no significant difference was found in the VAS score at 12 months postoperatively between the two groups(P>0.05). There was no traumatic arthritis in any groups. Besides joint stiffness in 1 patient in the modified group and 2 patients in the traditional group, there were 2 patients with flexor tendon irritation and 2 patients with carpal tunnel syndrome in the traditional group. The symptoms were relieved in patients wi

关 键 词：Henry入路 桡骨远端骨折 AO分型 掌侧接骨板 

分 类 号：R683.41[医药卫生—骨科学]