两种入路开放复位内固定桡骨远端骨折的比较  

Comparison of two approaches for open reduction and internal fixation of distal radius fractures

作　　者：何序昉 胡勇[1] 陶岳峰 舒尺祥 左贵松 HE Xu-fang;HU Yong;TAO Yue-feng;SHU Chi-xiang;ZUO Gui-song(The First Affiliated Hospital,Anhui Medical University,Hefei,Anhui 230032,China;Anqing Medical Center,Anhui Medical University,Anqing,Anhui 246003,China)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230032 [2]安徽医科大学安庆医学中心,安徽安庆246003

出　　处：《中国矫形外科杂志》2025年第7期597-603,共7页Orthopedic Journal of China

摘　　要：[目的]探讨桡侧腕屈肌腱(flexor carpi radialis tendon,FCRT)入路与桡骨远端Henry入路内固定治疗C3型桡骨远端骨折的疗效。[方法]回顾性分析本院2018年1月—2023年1月收治的100例C3型桡骨远端骨折患者的临床资料。依据不同时间段,后期的54例患者采用FCRT入路,早期的46例患者采用传统的Henry入路。对比两组围手术期、随访及影像指标。[结果]两组患者均成功完成手术。FCRT组骨折显露时间[(10.5±1.0)min vs(13.6±1.2)min,P<0.001]、手术时间[(56.4±5.3)min vs(60.0±6.4)min,P=0.003]、术中失血量[(20.0±3.6)mL vs(23.5±4.0)m L,P<0.001]均显著优于Henry组。随访时间平均(24.0±3.0)个月,FCRT组恢复完全负重活动时间[(80.5±7.5)d vs(84.0±8.6)d,P=0.032]显著早于Henry组,与术后1个月相比,末次随访时,两组VAS评分、DASH评分、G-W评分、腕伸-屈ROM、尺偏-桡偏ROM、旋前-旋后ROM均显著改善(P<0.05),术后1个月,FCRT组VAS评分[(2.3±0.4)vs(2.8±0.6),P<0.001]、DASH评分[(14.0±3.2)vs(15.7±4.2),P=0.024]、G-W评分[(8.0±1.8)vs(9.1±2.0),P=0.005]均显著优于Henry组。影像方面,两组关节面复位情况比较差异无统计学意义(P>0.05)。与术前相比,末次随访,两组掌倾角(palmar tilt,PT)、尺偏角(radial inclination,RI)、桡骨高度(radial length,RL)均显著增加(P<0.05),相应时间点,两组上述影像指标的差异均无统计学意义(P>0.05)。[结论]与传统Henry入路相比,桡侧腕屈肌腱(flexor carpi radialis tendon,FCRT)入路开放复位内固定C3型桡骨远端骨折可显著减少手术创伤,更有利于早期功能恢复。[Objective]To compare the clinical efficacy of open reduction and internal fixation(ORIF)through flexor carpi radialis tendon(FCRT)approach versus conventional Henry approach for type C3 distal radius fractures.[Methods]A retrospective study was conducted on 100 patients received ORIF for type C3 distal radius fracturesin our hospital from January 2018 to January 2023.According to different time periods,54 patients in the late stage were treated through the FCRT approach,while 46 patients in the early stage were treated through the traditional Henry approach.The perioperative period,follow-up and imaging documents of the two groups were compared.[Results]All patients in both groups had operation completed successfully.The FCRT group was significantly superior to the Henry group in terms of fracture exposure time[(10.5±1.0)min vs(13.6±1.2)min,P<0.001],operation time[(56.4±5.3)min vs(60.0±6.4)min,P=0.003],intraoperative blood loss[(20.0±3.6)mL vs(23.5±4.0)mL,P<0.001].The average follow-up time was of(24.0±3.0)months,and the FCRT group resumed full weight-bearing activity significantly earlier than the Henry group[(80.5±7.5)d vs(84.0±8.6)d,P=0.032].The VAS score,DASH score,G-W score,wrist extension-flexion ROM,ulnar-radial ROM and pronation-supination ROM were significantly improved in both groups at the last follow-up compared with those 1 month after surgery(P<0.05).FCRT group was significantly better than the Henry group in terms of VAS score[(2.3±0.4)vs(2.8±0.6),P<0.001],the DASH score[(14.0±3.2)vs(15.7±4.2),P=0.024],the G-W score[(8.0±1.8)vs(9.1±2.0),P=0.005]one month postoperatively.As for imaging,there was no a significant difference in articular surface reduction between the two groups(P>0.05).The palmar tilt(PT),radial inclination(RI)and radial length(RL)in both groups were significantly increased at the latest follow-up compared with those preoperatively(P<0.05),whereas which were not statistically significant between the two groups at any matching time points(P>0.05).[Conclusion]The open re

关 键 词：C3型桡骨远端骨折 桡侧屈肌腱入路 桡骨远端Henry入路 内固定 

分 类 号：R683.41[医药卫生—骨科学]