经桡侧腕屈肌腱入路切开复位内固定术治疗桡骨远端骨折的效果及对骨折愈合、腕关节功能的影响研究  

Study on the Therapeutic Effect of Open Reduction and Internal Fixation Through the Radial Flexor Tendon Approach for the Treatment of Distal Radius Fractures and its Impact on Fracture Healing and Wrist Joint Function

作　　者：黄耀永 HUANG Yaoyong(Chang'an Wusha Hospital,Chang'an Town,Dongguan,Guangdong 523000)

机构地区：[1]东莞市长安镇长安乌沙医院外二科(骨科),广东东莞523000

出　　处：《智慧健康》2025年第2期38-41,共4页Smart Healthcare

摘　　要：目的研究经桡侧腕屈肌腱入路切开复位内固定术治疗桡骨远端骨折的疗效及对骨折愈合、腕关节功能的影响。方法回顾性选择本院2021年1月—2023年12月收治的60例桡骨远端骨折患者为研究对象,根据手术治疗路径的不同将其分为RC组30例和ZC组30例。RC组患者经桡侧腕屈肌腱入路行切开复位内固定术治疗,ZC组患者经直接掌侧入路行切开复位内固定术治疗。对比两组患者手术指标、术后并发症的发生率、疼痛介质指标[前列腺素E2(PGE2)、5-羟色胺(5-HT)]、骨折愈合时间、腕关节功能(COOney腕关节评分法)。结果RC组患者并发症发生率为3.33%,低于ZC组的16.67%(P<0.05)。术后,RC组患者血清PGE2、5-HT均低于ZC组(P<0.05)。RC组患者骨折愈合时间短于ZC组(P<0.05)。RC组患者术后3个月腕关节功能优良率为83.33%,高于ZC组的70%(P<0.05)。结论相较于经直接掌侧入路,经桡侧腕屈肌腱入路切开复位内固定术治疗桡骨远端骨折的并发症发生率更低,且患者疼痛程度轻,骨折愈合效果和腕关节功能恢复效果更好。Objective To investigate the efficacy of open reduction and internal fixation through the radial flexor tendon approach for the treatment of distal radius fractures and its impact on fracture healing and wrist joint function.Methods A retrospective study was conducted on 60 patients with distal radius fractures admitted to our hospital from January 2021 to December 2023.According to different surgical treatment paths,they were divided into RC group(30 cases)and ZC group(30 cases).Patients in the RC group underwent open reduction and internal fixation via the radial flexor tendon approach,while patients in the ZC group underwent open reduction and internal fixation via the direct palmar approach.Compare the surgical indicators,incidence of postoperative complications,pain mediator indicators[prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)],fracture healing time,and wrist joint function(COOney wrist joint scoring method)between two groups of patients.Results The incidence of complications in the RC group was 3.33%,which was lower than the 16.67% in the ZC group(P<0.05).After surgery,the serum levels of PGE2 and 5-HT in the RC group were lower than those in the ZC group(P<0.05).The fracture healing time of RC group patients was shorter than that of ZC group(P<0.05).The excellent and good rate of wrist joint function in RC group patients 3 months after surgery was 83.33%,which was higher than the 70% in ZC group(P<0.05).Conclusion Compared with the direct palmar approach,the radial flexor tendon approach for open reduction and internal fixation of distal radius fractures has a lower incidence of complications,less pain,better fracture healing and wrist joint function recovery in patients.

关 键 词：桡骨远端骨折 桡侧腕屈肌腱入路 直接掌侧入路 疼痛介质 骨折愈合 腕关节功能 

分 类 号：R68[医药卫生—骨科学]