摘要
目的 比较桡骨远端Henry入路、经桡侧腕屈肌腱入路与直接掌侧入路在桡骨远端骨折切开复位锁定加压接骨板内固定术中应用的效果。方法 回顾性分析自2013-07—2016-09采用掌侧入路切开复位锁定加压接骨板内固定治疗的109例桡骨远端骨折,37例采用桡骨远端Henry入路（A组）,39例采用桡侧腕屈肌腱入路（B组）,33例采用直接掌侧入路（C组）。比较3组骨折显露时间、手术时间、正中神经损伤发生率、桡动静脉及其分支损伤发生率,术后12个月时桡骨高度、尺偏角、掌倾角、腕关节功能Gartland-Werley评分。结果 109例均获得随访,随访时间12～38个月,平均16.2个月。B组骨折显露时间、手术时间较A组和C组短,而A组骨折显露时间、手术时间较C组短,差异有统计学意义（P 〈0.05）。3组术后12个月时桡骨高度、尺偏角、掌倾角、腕关节功能Gartland-Werley评分比较差异无统计学意义（P〉0.05）。C组正中神经损伤发生率高于A组和B组,A组桡动静脉及其分支损伤发生率高于B组和C组,差异有统计学意义（P 〈0.05）。结论 桡侧腕屈肌腱入路与直接掌侧入路、Henry入路相比,术中无需解剖显露神经血管,故骨折显露时间及手术时间均较短,桡动静脉及其分支损伤发生率、正中神经术后并发症发生率均较低。
Objective To compare the effects of Henry approach, flexor carpi radialis tendon approach and direct volar approach in open reduction and locking compression plate internal fixation of distal radius fractures. Methods A retrospective analysis of 109 cases of distal radius fractures treated by open reduction and locking compression plate internal fixation through volar approaches from July 2013 to September 2016 was conducted, 37 cases by Henry approach （group A）, 39 cases by flexor carpi radialis tendon approach （group B）, 33 cases by direct volar approach （group C）. Fracture exposure time, operation time, median nerve injury rate, radial artery and vein and its branches injury rate, as well as the radial height, ulnar deviation angle, palmar tilt angle, wrist joint function Gartland-Werley score at 12 months after operation were compared among the three groups. Results All 109 patients were followed up for 12-38 months, with an average of 16.2 months. The exposure time and operation time of group B were shorter than those of group A and group C, while the exposure time and operation time of group A were shorter than those of group C. The differences were statistically significant （P 〈0.05）. There was no statistically significant differences （P 〉0.05） in Gartland-Werley scores of radial height, ulnar deviation angle, palmar tilt angle and wrist function between the three groups at 12 months after operation. The incidence of median nerve injury in group C was higher than that in group A and group B, while the incidence of radial artery and vein injury in group A was higher than that in group B and group C, the differences were statistically significant （P 〈0.05）. Conclusion Compared with the direct volar approach and Henry approach, the radial flexor carpi tendon approach does not require anatomical exposure of nerves and vessels during operation. As a result, the exposure time and operation time of fracture are shorter, the incidence of injury of radial artery and vein and its branches and the incidence of postoperative complications of median nerve are lower.
作者
王新武
罗元标
林宗锦
王新标
WANG Xing-wu;LUO Yuan-biao;LIN Zong-jin;WANG Xing＇biao(Department of orthopedics,Putian NO.1 Hospital,Putian,Fujian 351100,China)
出处
《中国骨与关节损伤杂志》
2018年第11期1143-1146,共4页
Chinese Journal of Bone and Joint Injury
关键词
桡骨远端骨折
桡侧腕屈肌腱入路
Henry入路
直接掌侧入路
锁定钢板
内固定
Distal radius fractures
Radial flexor carpi tendon approach
Henry approach
Direct volar approach
Locking plate
Internal fixation
