摘要
目的对比保留旋前方肌掌侧微创入路与传统Henry入路治疗老年桡骨远端骨折的临床疗效。方法选取2016年1月至2019年1月在航天中心医院骨科住院治疗的老年桡骨远端骨折患者46例进行回顾性分析。依据治疗方法分为2组:微创组和对照组,每组各23例。微创组采取保留旋前方肌掌侧微创入路锁定钢板螺钉内固定术;对照组采取传统切开旋前方肌Henry掌侧入路钢板螺钉内固定术。比较2组患者手术切口长度、术中出血量、手术并发症、术后住院时间、骨折复位情况(掌倾角和尺偏角)及术后3个月腕关节功能恢复情况。采用SPSS 20.0软件进行数据处理。依据数据类型,组间比较采用t检验或χ2检验。结果与对照组相比,微创组患者的切口长度[(2.4±0.3)和(7.2±1.4)cm]、术中出血量[(13.2±2.1)和(31.2±4.1)ml]和术后住院时间[(4.6±0.9)和(7.5±1.2)d]均显著减少(P<0.05)。2组患者术后均未发生手术并发症。微创组患者术后3个月的视觉模拟量表(VAS)评分显著低于对照组[(0.5±0.2)和(2.2±0.4)分,P<0.05],而Gartland-Werley评分达优率(95.65%和73.91%)和腕关节旋前角度(83.8°±10.8°和74.6°±9.5°)均显著高于对照组(P<0.05)。结论保留旋前方肌掌侧微创入路钢板螺钉内固定治疗老年桡骨远端骨折的疗效较好,且手术切口小,术中出血量少,术后3个月腕关节整体功能恢复好。
Objective To compare the clinical efficacy of minimally invasive surgery with preservation of palmar side of pronator quadratus versus traditional Henry approach in the treatment of distal radius fractures in the elderly.Methods A retrospective study was carried out on 46 elderly patients with distal radius fracture treated in our department from January 2016 to January 2019.The patients were divided into minimally invasive group and control group,with 23 cases in each group.The minimally invasive group was treated by internal fixation with locking plate and screw and preservation of pronator quadratus,while the control group was treated with traditional open Henry volar approach of pronator quadratus muscle combined with internal fixation of plate and screw.The length of incision,intraoperative bleeding volume,complications,length of hospital stay,reduction of fracture and wrist joint function in 3 months after operation were compared between the two groups.SPSS statistics 20.0 was used to perform the statistical analysis.Student′s t test or Chi-square test was employed in intergroup comparison for different data types.Results Compared with the control group,the incision length[(2.4±0.3)vs(7.2±1.4)cm]and the intraoperative bleeding volume[(13.2±2.1)vs(31.2±4.1)ml]were significantly less,and postoperative length of hospital stay[(4.6±0.9)vs(7.5±1.2)d]was obviously shorter in the minimally invasive group(P<0.05).No postoperative complications occurred in both groups.The visual analogue scale(VAS)scores of the patients were notably lower in the minimally invasive group than the control group[(0.5±0.2)vs(2.2±0.4),P<0.05],while the rates of the patients with better Gartland-Werley scores(95.65%vs 73.91%)and the wrist pronation angles[(83.8°±10.8°)vs(74.6°±9.5°)]were significantly larger in the former group than the latter group(P<0.05).Conclusion Minimally invasive surgery with preservation of palmar side of pronator quadratus and internal fixation with locking plate and screw exerts good efficacy in the treatment of distal radius fractures in the elderly,with small incision,less intraoperative bleeding,and sound overall wrist function in 3 months after operation.
作者
顾锋
梁永辉
刘申
李新天
郭文杰
李青松
韦兴
GU Feng;LIANG Yong-Hui;LIU Shen;LI Xin-Tian;GUO Wen-Jie;LI Qing-Song;WEI Xing(Department of Orthopaedics, Aerospace Center Hospital, Beijing 100049, China)
出处
《中华老年多器官疾病杂志》
2020年第7期504-507,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
老年人
旋前方肌
桡骨远端骨折
微创
aged
pronator quadratus muscle
distal radius fracture
minimal invasion
