摘要
目的探讨采用Henry入路掌侧解剖型锁定钢板内固定治疗不稳定性桡骨远端骨折的疗效。方法回顾性分析2018年1月至2020年12月我科行Henry入路掌侧解剖型锁定钢板内固定治疗的64例不稳定性桡骨远端骨折患者的临床资料,年龄16~83岁,平均55岁,均为新鲜闭合性单侧骨折。骨折AO分型:A3型16例,B3型18例,C1型14例,C2型9例,C3型7例。比较手术前后患者掌倾角、尺偏角及桡骨茎突高度,术后患侧与健侧的腕关节活动度及握力,采用Gartland-Werley评分评估腕关节功能。结果所有患者均顺利完成手术。术后3 d复查X线示掌倾角、尺倾角基本恢复,关节面平整,掌倾角、尺偏角及桡骨茎突高度均较术前明显改善,差异均有统计学意义(P<0.05)。术后1个月患侧手部握力及腕关节活动度均小于健侧,差异有统计学意义(P<0.05),至术后3个月两侧比较无统计学差异(P>0.05)。所有患者均获随访,随访时间12~16个月,平均13.6个月。无感染、肌腱断裂、螺钉松动、骨折移位及骨不愈合等并发症发生。复查X线示骨折均愈合,愈合时间8~14周,平均11.4周。末次随访腕关节功能Gartland-Werley评分:优43例,良15例,可6例,优良率达90.6%。结论Henry入路解剖型锁定钢板内固定治疗不稳定性桡骨远端骨折手术操作简单,骨折固定可靠,有利于腕关节功能早期恢复,值得推广应用。
Objective To analyze the efficacy of internal fixation with anatomic volar locking plate via Henry approach in the treatment of unstable distal radius fractures.Methods The clinical data of 64 cases(aged from 16 to 83 years,mean 55 years)with unstable distal radius fractures underwent internal fixation of anatomic volar locking plate via Henry's approach in our hospital from January 2018 to December 2020 were selected and analyzed retrospectively.The fracture was fresh,closed and unilateral in all 64 cases.There was type A3 in 16,type B3 in 18,type C1 in 14,type C2 in 9 and type C3 in 7 according to AO classification.The palm inclination angle,ulnar deviation angle and the height of radius styloid process were compared between pre-and post-operation,as well as the wrist joint activity and grip strength between the injured and healthy side after the surgery.The wrist joint function was evaluated with Gartland-Werley score.Results All operations were complete successfully.X-ray showed that the palm angle and ulnar angle were recovered and the joint surface was flat.The metacarpal angle,ulnar deviation angle and height of radius styloid process after the operation were improved significantly than those before the operation(P<0.05).The grip strength of hand and motion range of wrist joint were less in injured side than those in uninjured side one month after the operation,the difference were significantly(P<0.05),but there was no obvious difference between the two sides three months after the operation(P>0.05).All 64 patients were followed up for 12 to 16 months with an average of 13.6 months.There was no postoperative complication such as infection,tendon rupture,screw loosening,fracture displacement and fracture nonunion.All fractures healed in 8 to 14 weeks with an average of 11.4 weeks.According to Gartland-Werley score,the wrist joint function revealed that excellent in 43 cases,good in 15 cases,fair in 6 cases,and the fineness rate was 90.6%.Conclusion The method of internal fixation of anatomical locking plate via Henry approach is simple and reliable for unstable distal radius fractures,which is conductive to recovery the wrist joint function early.
作者
周传友
疏建
程恺
周骏武
Zhou Chuanyou;Shu Jian;Cheng Kai;Zhou Junwu(Department of Orthopaedics,the People's Hospital of Chizhou,Chizhou 247000,Anhui,China)
出处
《中国现代手术学杂志》
2023年第1期33-37,共5页
Chinese Journal of Modern Operative Surgery
