摘要
目的探讨改良Henry入路保留旋前方肌内固定术在桡骨远端骨折中的治疗价值,分析患者的远期预后。方法回顾性选取我院2021年2月至2023年2月收治的桡骨远端骨折患者100例,按照手术方式的不同分成对照组与改良组各50例。对照组行常规Henry入路内固定术,改良组行改良Henry入路保留旋前方肌内固定术。比较两组临床疗效、手术时间、出血量、骨折暴露时间。于术前、术后3个月检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)、C反应蛋白(CRP)水平,在术前及术后3、6个月进行视觉模拟疼痛评分(VAS)、Cooney腕关节评分。比较两组术前及术后6、12个月的腕关节屈曲、背伸及前臂旋转范围,记录术后1 d及12个月的桡骨高度,计算桡骨丢失高度,并分析并发症情况。结果100例患者获得成功随访,随访率时间12个月。改良组(96.00%)优良率较对照组(82.00%)更高(P<0.05)。改良组出血量较对照组降低,手术时间、骨折暴露时间较对照组缩短(P<0.05)。两组术后3个月血清MDA、CRP水平较术前降低,SOD较术前增高,且改良组术后MDA、CRP较对照组更低,SOD较对照组更高(P<0.05)。两组术后3、6个月的VAS评分较术前降低,Cooney评分较术前增高,且改良组术后3、6个月的VAS评分较对照组更低,Cooney评分较对照组更高(P<0.05)。两组术后6、12个月腕关节屈曲、背伸及前臂旋转范围均较术前增高,且改良组较对照组更高(P<0.05)。改良组桡骨丢失高度较对照组更低(P<0.05)。两组并发症率比较无差异(P>0.05)。结论改良Henry入路保留旋前方肌内固定术能提升桡骨远端骨折患者的近期疗效,缩短手术及骨折暴露时间,减少出血量,减轻术后炎症与应激反应,进一步改善远期腕关节活动范围,减少桡骨丢失高度,安全性高。
Objective To evaluate the therapeutic value of modified Henry approach for the treatment of distal radius fractures and to analyze the long-term prognosis of patients.Methods A total of 100 patients with distal radius fracture admitted to our hospital from February 2021 to February 2023 were retrospectively selected and divided into control group and improved group with 50 cases in each group according to different surgical methods.The control group underwent conventional Henry approach internal fixation,and the improved group underwent modified Henry approach to preserve anterior rotation intramural fixation.The clinical effect,operation time,blood loss and fracture exposure time of the two groups were compared.Serum malondialdehyde(MDA),superoxide dismutase(SOD)and C-reactive protein(CRP)levels were detected before surgery and 3 months after surgery.Visual analogue pain scale(VAS)and Cooney wrist joint score were performed before surgery and 3 and 6 months after surgery.Wrist flexion,dorsal extension and forearm rotation were compared between the two groups before surgery and 6 and 12 months after surgery.Radius height was recorded 1d and 12 months after surgery,radius loss height was calculated,and complications were analyzed.Results 100 patients were successfully followed up for 12 months.The excellent and good rate of the improved group(96.00%)was higher than that of the control group(82.00%)(P<0.05).The blood loss in the improved group was lower than that in the control group,and the operation time and fracture exposure time were shorter than that in the control group(P<0.05).The levels of MDA and CRP were lower and the levels of SOD were higher in the two groups 3 months after operation,and MDA and CRP were lower and SOD were higher in the improved group than in the control group(P<0.05).VAS score of 3 and 6 months after surgery was lower in 2 groups than before surgery,Cooney score was higher than before surgery,and VAS score of 3 and 6 months after surgery in the improved group was lower than that in the control group,Cooney score was higher than that in the control group(P<0.05).Wrist flexion,dorsal extension and forearm rotation were higher in 2 groups 6 and 12 months after surgery than before surgery,and the improved group was higher than the control group(P<0.05).The height of radius loss in the improved group was lower than that in the control group(P<0.05).There was no difference in complication rate between 2 groups.Conclusion The modified Henry approach can improve the short-term efficacy of patients with distal radius fractures,shorten the operation and fracture exposure time,reduce the amount of blood loss,reduce postoperative inflammation and stress response,further improve the long-term wrist range of motion,reduce the height of radius loss,and have high safety.
作者
李政
陆永刚
杨轶婷
聂升波
刘敏杰
杨勇
季小娟
樊健
Li Zheng;Lu Yonggang;Yang Yiting;Nie Shengbo;Liu Minjie;Yang Yong;Ji Xiaojuan;Fan Jian(Affiliated Qidong Hospital of Nantong University/Qidong People's Hospital/Qidong Liver Cancer Institute,Nantong 226200,China;Department of Orthopaedic,Shanghai Tongji Hospital,Shanghai 200065,China)
出处
《中华老年骨科与康复电子杂志》
2025年第2期117-122,共6页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
南通大学临床医学专项科研基金项目(2023LZ003)
上海市医学创新研究专项项目(20Y11912600)。
关键词
改良Henry入路
桡骨远端骨折
炎症
桡骨高度
远期预后
Improved Henry approach
Fracture of distal radius
Inflammation
Radius height
Long term prognosis
