摘要
[目的]探讨经肱桡肌腱-旋前方肌复合体入路治疗不稳定桡骨远端骨折的临床疗效。[方法] 2015年10月～2016年6月,本科采用经肱桡肌腱-旋前方肌复合体入路锁定接骨板治疗不稳定性桡骨远端骨折患者52例。并通过随访比较患侧、健侧的腕关节活动度以及最终的Gartland-Werley评分来评估临床疗效。[结果] 52例患者均顺利手术,未发生血管、神经和肌腱损伤及前臂骨筋膜室综合征等并发症,切口愈合良好。其中50例患者随访(12.96±1.09)个月。术后12周测量患侧与健侧腕关节活动度,两侧在掌屈、背伸、旋前、旋后、桡偏和尺偏的差异均无统计学意义(P>0.05)。影像检查显示所有的骨折均在8个月达到骨愈合,桡骨远端无畸形,桡骨的高度和宽度无继发改变,内固定物无松动及断裂,下尺桡关节匹配良好。末次随访时按Gartland-Werley腕关节临床评定标准,优37例,良11例,中2例,差0例,优良率为96.00%。[结论]经肱桡肌腱-旋前方肌复合体入路治疗不稳定桡骨远端骨折,腕关节功能可以更早、更好地恢复,临床疗效好。
[Objective] To investigate the clinical outcomes of volar plate through an approach between pronator quadratus and brachioradialis for the unstable distal radius fracture. [Methods] From October 2015 to June 2016, a total of 52 patients underwent open reduction and internal fixation with volar interlocking plate through an approach between pronator quadratus and brachioradialis for unstable distal radius fractures in our department. The clinical outcomes were evaluated by comparison of bilateral wrist range of motions(ROM) and using the Gartland-Werley criteria. [Results] The 52 patients had operation done successfully without serious complications, such as neurovascular injuries and compartment syndrome, whereas with the incisions healed well. Of them, 50 patients were followed up for an average of(12.96±1.09) months. At 12 weeks, all of the 50 patients returned to satisfactory ROM without statistically significant differences between the injured side and the unaffected side in flexion/extension, pronation/supination and radial/ulna deviations(P>0.05). Radiographs revealed fracture healing in all of them within 8 months, no distal radius deformity as well as secondary variation in distal radial height and width, no loosening or break of implant, whereas well fitted distal radioulnar joint. At the latest follow up, the clinical outcomes were graded as excellent in37, good in 11 and fair in 2, associated with the excellent and good rate of 96.00%. [Conclusions] The volar plate through the approach between pronator quadratus and brachioradialis does achieve improved clinical outcomes for the unstable distal radius fracture. It facilitates early rehabilitation of wrist function.
作者
廖明新
曾卡斌
陈小杰
LIAO Ming-xin;ZENG Ka-bin;CHEN Xiao-jie(The Nanping First Hospital Affiliated to Fujian Medical University, Nanping 353000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第2期132-136,共5页
Orthopedic Journal of China
关键词
桡骨远端骨折
旋前方肌
肱桡肌腱
锁定钢板
distal radius fracture
pronator quadratus
brachioradialis
locking plate
