改良Henry入路保留旋前方肌掌侧锁定钢板内固定治疗桡骨远端骨折疗效分析  

Clinical Efficacy of Modified Henry Approach with Preservation of Pronator Quadratus for Volar Locking Plate Internal Fixation in the Treatment of Distal Radius Fracture

作　　者：黎成成 殷子敬 张云航 区钰强 LI Chengcheng;YIN Zijing;ZHANG Yunhang;OU Yuqiang(DepartmentⅢof Orthopedics,Zhaoqing Hospital of TCM,Zhaoqing,Guangdong 526000,China)

机构地区：[1]肇庆市中医院骨三科,广东肇庆526000

出　　处：《中国烧伤创疡杂志》2024年第3期214-217,236,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探讨改良Henry入路保留旋前方肌掌侧锁定钢板内固定治疗桡骨远端骨折的临床疗效。方法选取2018年1月至2022年1月肇庆市中医院收治的84例桡骨远端骨折患者作为研究对象,按照不同手术方法将其分为观察组(42例)和对照组(42例),观察组患者采用改良Henry入路保留旋前方肌掌侧锁定钢板内固定治疗,对照组患者采用改良Henry入路离断旋前方肌掌侧锁定钢板内固定治疗,对比观察两组患者上肢功能障碍评定量表(Quick-DASH)评分、腕关节功能患者自行评估量表(PRWE)评分、Mayo腕关节功能评分(简称Mayo评分)、视觉模拟评分法(VAS)评分及不良事件发生情况。结果术后1、6个月,观察组患者Quick-DASH、PRWE及VAS评分均明显低于对照组,Mayo评分明显高于对照组(术后1个月:t=3293、4123、2902、2366,P=0002、P<0001、P=0005、P=0020;术后6个月:t=4877、4136、2139、2695,P<0001、P<0001、P=0035、P=0009);观察组患者术后不良事件发生率为714%,明显低于对照组患者的术后不良事件发生率2381%(χ^(2)=4459,P=0035)。结论桡骨远端骨折采用改良Henry入路保留旋前方肌掌侧锁定钢板内固定治疗更能明显减轻患者疼痛,促进上肢功能及腕关节功能恢复,降低术后不良事件发生风险。Objective To study the clinical efficacy of modified Henry approach with preservation of pronator quadratus for volar locking plate internal fixation in the treatment of distal radius fracture.Methods 84 patients with distal radius fractures admitted to Zhaoqing Hospital of TCM from January 2018 to January 2022 were enrolled as the research subjects and divided,according to the surgical methods they received,into the study group(n=42)and the control group(n=42).Patients in the study group were treated with modified Henry approach with preservation of pronator quadratus for volar locking plate internal fixation,whereas patients in the control group with the modified Henry approach with amputation of pronator quadratus for volar locking plate internal fixation.The following indicators,including scores of quick disabilities of the arm,shoulder and hand(Quick-DASH),patient-rated wrist evaluation(PRWE),Mayo wrist score(Mayo score),and visual analogue scale(VAS),and the incidence of adverse reactions,were compared between the two groups.Results At month 1 and 6 after surgery,the scores of Quick-DASH,PRWE and VAS of patients were all significantly lower in the study group compared with the control group,and the Mayo score was significantly higher in the study group(month 1 after surgery:t=3293,4123,2902 and 2366,P=0002,P<0001,P=0005,P=0020;month 6 after surgery:t=4877,4136,2139 and 2695,P<0001,P<0001,P=0035,P=0009).The incidence of postopera-tive adverse reactions of patients in the study group was 714%,being much lower than 2381%in the control group(χ^(2)=4459,P=0035).Conclusion Treating distal radius fracture with modified Henry approach with preservation of pronator quadratus for volar locking plate internal fixation can significantly alleviate patients’pain,promote the recovery of upper limb and wrist joint function,and reduce the occurrence of adverse reactions.

关 键 词：桡骨远端骨折 Henry入路 掌侧锁定钢板 保留旋前方肌 疼痛 上肢功能 腕关节功能 

分 类 号：R687.3[医药卫生—骨科学]