经旋前方肌下肌骨通道保留旋前方肌内固定治疗桡骨远端骨折  

Treatment of distal radius fracture by reserving pronator quadratus internal fixation via musle-bone channel of inferior pronator quadratus

作　　者：郭永杰 徐建 刘赟 盛飞 GUO Yong-jie;XU Jian;LIU Yun;SHENG Fei(Dept of Orthopaedics,the Second Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241000,China)

机构地区：[1]皖南医学院第二附属医院骨科,安徽芜湖241000

出　　处：《临床骨科杂志》2024年第2期238-242,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨经旋前方肌下肌骨通道保留旋前方肌内固定治疗桡骨远端骨折的疗效。方法将100例桡骨远端骨折患者根据是否保留旋前方肌分为对照组(采用倒L形切口切开旋前方肌内固定治疗,54例)和观察组(采用经旋前方肌下肌骨通道保留旋前方肌内固定治疗,46例)。记录骨折复位及愈合情况、疼痛VAS评分、腕关节影像学指标、前臂及腕关节活动度、Gartland-Werley评分。结果患者均获得随访,时间12~20个月。术后X线片显示:骨折均对位对线良好,关节面恢复平整,达到解剖复位。两组骨折均愈合良好,时间2.7~5.5个月。术后6周疼痛VAS评分、前臂旋前及旋后活动度、Gartland-Werley评分观察组均优于对照组(P<0.05);末次随访时前臂旋前活动度观察组大于对照组(P<0.05),前臂旋后活动度、Gartland-Werley评分两组比较差异均无统计学意义(P>0.05)。末次随访时腕关节掌屈、背伸活动度及掌倾角、尺偏角两组比较差异均无统计学意义(P>0.05)。结论经旋前方肌下肌骨通道保留旋前方肌内固定治疗桡骨远端骨折,可缩短患者康复时间,最大程度保留前臂旋前功能,且安全有效。Objective To investigate the efficacy of reserving pronator quadratus internal fixation via musle-bone channel of inferior pronator quadratus in the treatment of distal radius fracture.Methods The 100 patients with distal radius fractures were divided into control group(54 cases were treated with inverted L-shaped incision opening pronaotor quadratus internal fixation)and observation group(46 cases were treated with reserving pronator quadratus internal fixation via musle-bone channel of inferior pronator quadratus),according to whether or not reserving pronator quadratus.Fracture reduction and healing,pain VAS,wrist imaging indicators,range of motion of the forearm and wrist,Gartland-Werley score were recorded.Results All patients were followed up for 12~20 months.Postoperative radiographs showed good alignment of fractures,flat recovery of joint surface and anatomical reduction.The fractures healed well in 2.7~5.5 months.At 6 weeks after operation,pain VAS,pronation and supination ranges of forearm,Gartland-Werley scores were all better in the observation group than those in the control group(P<0.05).At the last follow-up,the forearm pronation activity range in the observation group was larger than that in the control group(P<0.05).There were no statistical differences in forearm supination range and Gartland-Werley scores between the two groups(P>0.05).At the last follow-up,there were no statistical differences in the range of motion of carpal flexion,dorsal extension,palmar inclination and ulnar deviation of the wrist joint between the two groups(P>0.05).Conclusions The treatment of distal radius fracture with reserving pronator quadratus internal fixation via musle-bone channel of inferior pronator quadratus can shorten the recovery time,reserve forearm pronation function to the maximum extent,and it is safe and effective.

关 键 词：桡骨远端骨折 掌侧锁定钢板 保留旋前方肌 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]