老年桡骨远端骨折内固定术中保留与离断旋前方肌疗效对比  

Comparison of Clinical Efficacy of Preservation and Amputation of Pronator Quadratus in Internal Fixation of Distal Radius Fracture in Elderly Patients

作　　者：马占伟 贾光辉[2] 楚利涛[3] MA Zhanwei;JIA Guanghui;CHU Litao(Department of Orthopedics,Shangcai Chongyang Hospital,Shangcai,Henan 463800,China;Department of Foot and Ankle Surgery,Zhengzhou Orthopedic Hospital,Zhengzhou,Henan 452300,China;Department of Lower Limb Orthopedics,Zhengzhou Orthopedic Hospital,Zhengzhou,Henan 452300,China)

机构地区：[1]上蔡重阳医院骨科,河南上蔡县463800 [2]郑州市骨科医院足踝外科,河南郑州452300 [3]郑州市骨科医院下肢骨科,河南郑州452300

出　　处：《中国烧伤创疡杂志》2025年第2期144-146,151,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的对比分析老年桡骨远端骨折内固定术中保留与离断旋前方肌的临床疗效。方法选取2022年1月至2023年1月上蔡重阳医院收治的48例老年桡骨远端骨折患者作为研究对象,按照术中是否保留旋前方肌将其分为微创组(24例)与常规组(24例),两组均于掌侧Henry入路实施锁定钢板内固定治疗,但微创组患者术中保留旋前方肌,常规组患者术中离断旋前方肌,对比观察两组患者手术相关指标及骨折部位解剖结构。结果微创组患者术中出血量明显少于常规组(t=6.596,P<0.001),而手术时间与常规组无明显差异(t=0.702,P=0.486);术后2 d,微创组患者尺骨茎突高度明显低于常规组(t=2.658,P=0.011),而背侧成角角度、桡侧成角角度与常规组无明显差异(t=1.327、1.657,P=0.191、0.104)。结论老年桡骨远端骨折内固定术中保留旋前方肌,能够显著减轻二次损伤程度,更有利于恢复骨折部位解剖结构。Objective To compare the clinical efficacy of preservation and amputation of pronator quadratus in internal fixation of distal radius fracture in elderly patients.Methods48 elderly patients with distal radius fracture admitted to Shangcai Chongyang Hospital from January 2022 to January 2023 were enrolled as research subjects.Based on whether the pronator quadratus was preserved during surgery,they were divided into the minimally invasive group(n=24)and the conventional group(n=24).Patients in both groups were treated with volar Henry approach for locking plate internal fixation,while patients in the minimally invasive group were treated with preservation of pronator quadratus and patients in the conventional group with amputation of pronator quadratus.The surgery-related indexes and the anatomical structures of the fracture site were compared between the two groups.Results The intraoperative blood loss of patients in the minimally invasive group was significantly less than that of the conventional group(t=6.596,P<0.001).There was no significant difference in the operation duration between the two groups(t=0.702,P=0.486).On day 2 after surgery,the ulnar styloid height in the minimally invasive group was significantly lower than that in the conventional group(t=2.658,P=0.011).There were no significant differences in dorsal or radial angulation angles between the two groups(t=1.327 and 1.657,P=0.191 and 0.104).Conclusion Preserving the pronator quadratus during internal fixation of distal radius fracture in elderly patients can significantly reduce the degree of secondary injury and be more conducive to restoring the anatomical structure of the fracture site.

关 键 词：桡骨远端骨折 微创 老年 锁定钢板内固定 掌侧Henry入路 旋前方肌 腕关节 

分 类 号：R68[医药卫生—骨科学]