直接掌侧入路与桡侧腕屈肌腱入路手术治疗对桡骨远端骨折患者临床疗效的影响  

Clinical Effect of Direct Volar Approach and Radial Wrist Flexor Tendon Approach on Distal Radius Fracture Patients

作　　者：李堂五 张禹 王丰 LI Tang-wu;ZHANG Yu;WANG Feng(Department of Orthopedics,the First People's Hospital of Zhumadian,Zhumadian 463700,China)

机构地区：[1]驻马店市第一人民医院骨科,驻马店463700

出　　处：《四川解剖学杂志》2024年第3期1-3,7,共4页Sichuan Journal of Anatomy

摘　　要：目的:探讨直接掌侧入路、桡侧腕屈肌腱入路手术治疗对桡骨远端骨折患者的临床疗效、关节功能恢复以影响.方法:选取2020年3月至2022年12月本院收治的101例桡骨远端骨折患者作为研究对象.根据手术入路方式,将其分为观察组(n=52,桡侧腕屈肌腱入路)和对照组(n=49,直接掌侧入路).比较两组患者手术相关指标、关节功能及并发症发生率.结果:观察组患者手术时长、术后住院天数、骨折显露时长、骨折愈合时长均短于对照组,且术中总失血量、视觉模拟评分(VAS)均低于对照组,差异均有统计学意义(P<0.05).观察组患者术后6个月Gartland-Werley评分低于对照组,差异有统计学意义(P<0.05).观察组并发症发生率低于对照组,差异有统计学意义(P<0.05).结论:在临床实践中,采用桡侧腕屈肌腱入路与直接掌侧入路切开复位内固定治疗桡骨远端骨折患者,均具有良好疗效.但前者操作更为简便,无需解剖显露神经血管,大大缩短了骨折显露时长及手术时长,且促进腕关节功能的快速恢复,并减少患者并发症发生率.Objective:To explore the effect of direct volar approach and radial wrist flexor tendon approach on patients with distal radius fracture.Methods:A total of 101 patients with distal radius fractures admitted to our hospital from March 2020 to December 2022 were selected as research subjects.They were divided into observation group(n=52,radial wrist flexor tendon approach)and control group(n=49,direct metacarpal approach)according to the surgical approach.The operation related indexes,joint function and the incidence of complications were compared between the two groups.Results:The length of surgery,postoperative hospital days,length of fracture exposure,and length of fracture healing were shorter in observation group than those in control group,and the total intraoperative blood loss and visual analogue scale(VAS)score were lower in observation group than those in control group,the differences were statistically significant(P<0.05).The Gartland-Werley score was lower in observation group than that in control group at 6 months postoperatively,the difference was statistically significant(P<0.05).The complication rate of observation group was lower than that of control group,the difference was statistically significant(P<0.05).Conclusion:In clinical practice,the use of radial carpal flexor tendon approach and direct palmar approach to cut and reset internal fixation for distal radius fracture patients have good efficacy.However,the former is easier to operate,does not require dissection to reveal the nerves and blood vessels,greatly reduces the length of fracture exposure and operation time,and promotes the rapid recovery of wrist joint function and reduce the complication rate of patients.

关 键 词：直接掌侧 桡侧腕屈肌腱 桡骨远端骨折 临床疗效 关节功能 创伤应激 

分 类 号：R68[医药卫生—骨科学]