Background L-shaped incision of pronator quadratus （PQ） muscle along its radial and distal borders was always taken for distal radius fractures reduction and internal fixation.Repair of the PQ muscle was always reco...Background L-shaped incision of pronator quadratus （PQ） muscle along its radial and distal borders was always taken for distal radius fractures reduction and internal fixation.Repair of the PQ muscle was always recommended at the end of operation for some instructive reasons.But repair of PQ is not satisfied because of poor quality of muscle and fascial tissues which may cause pain or impede forearm pronation and supination for post-operative scarring around PQ.Inserting the locking palmar plate to pass under the pronator quadratus muscle and the locking screws are inserted through miniincisions in pronator quadratus in some patients with distal radius fractures is a reasonable technique which can preserve the pronator quadratus.The purpose of this study was to evaluate and compare the clinical effects after volar plating of the distal radius fractures while preserving the pronator quadratus and pronator quadratus repair.Methods Between September 2010 and April 2012,65 patients （42 males and 23 females; aged 20-68 years and a mean age of 42.5 years） with distal radius fracture underwent open reduction and internal fixation using the volar locking palmar plates （Depuy or Smith companies）.The patients were classified as 23A-2 through 23C-3 according to the Orthopaedic Trauma Association （OTA） classifications.All surgeries were completed by the same trained team.The volar locking palmar plates of distal radius performed with preserving pronator quadratus group involved 30 patients including 19 males and 11 females and performed with pronator quadratus repair group involved 35 patients including 23 males and 12 females.We compared the two groups for wrist pain,forearm range of motion,grip strength,pedoperative complications and wrist functional recovery score.Results The minimum follow-up for the whole cohort was one year.The differences between the two groups were significant with regard to wrist pain,forearm range of motion,grip strength and wrist function at 1,2,and 6 weeks postoperatively,but insi展开更多
目的探讨腋窝入路肩胛盂前缘骨折复位固定的可行性及临床疗效。方法取两具新鲜成人大体标本(4侧肩关节),模拟经腋窝入路行肩胛盂前缘骨折切开复位内固定手术。标本置于侧卧位,于腋后线切开,经背阔肌前侧肌肉间隙显露肩胛骨侧方,分离并...目的探讨腋窝入路肩胛盂前缘骨折复位固定的可行性及临床疗效。方法取两具新鲜成人大体标本(4侧肩关节),模拟经腋窝入路行肩胛盂前缘骨折切开复位内固定手术。标本置于侧卧位,于腋后线切开,经背阔肌前侧肌肉间隙显露肩胛骨侧方,分离并保护腋神经、旋肱后动脉、胸背神经及旋肩胛动脉等周围重要组织。腋窝入路下术野分为上侧"四边区"及下侧"三边区",可显露肩胛盂前下侧、肩胛颈及肩胛骨外侧缘全长。2018年4月至2020年12月采用腋窝入路肩胛盂切开复位内固定术治疗肩胛盂前缘骨折13例,男7例、女6例;年龄(50.38±13.74)岁(范围24~67岁);右肩12例、左肩1例,均为IdebergⅠa型骨折。采用解剖型支撑钢板固定5例、空心螺钉联合掌骨钢板固定7例、桡骨远端钢板固定1例。术后采用Constant-Murley评分、上肢功能评分(disabilities of the arm,shoulder and hand,DASH)评价临床疗效。结果全部病例均获得随访,随访时间(13.00±5.97)个月(范围6~26个月)。骨折均在6个月内愈合,无延迟愈合及畸形愈合。术后3个月Constant-Murley评分为(62.46±10.26)分(范围45~83分),DASH评分为(27.56±9.76)分(范围14.14~43.33分);术后6个月Constant-Murley评分为(80.85±8.32)分(范围65~90分),DASH评分为(11.47±8.56)分(范围0~35.00分);终末随访时Constant-Murley评分为(84.54±8.95)分(范围70~95分),DASH评分为(10.94±8.67)分(范围1.67~33.33分);随时间延长,关节功能逐渐恢复,术后3个月与术后6个月及末次随访时Constant-Murley评分和DASH评分的差异均有统计学意义(P<0.05)。结论腋窝入路是治疗肩胛骨前缘骨折安全、可行的入路;可显露肩胛盂前下侧和肩胛骨外侧缘,减少肩袖损伤,实现骨折解剖复位及坚强固定,并允许术后早期功能锻炼。展开更多
Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects...Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years （mean 57 years）.Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen （AO） standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days （mean 5 days）.All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively （mean 22 months）.The fractures healed within 10-18 weeks after operation （mean 12 weeks）.During the last follow-up,the mean palmar tilt was （7.0±0.9）° and the mean ulnar variance was （21.0±4.2）°,showing significant difference when compared with preoperation （（-5.0±1.2）° and （8.0±3.8）°）.The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5%.Conclusions The clinical effect of distal radius fracture treated with open reduction and int展开更多
文摘Background L-shaped incision of pronator quadratus （PQ） muscle along its radial and distal borders was always taken for distal radius fractures reduction and internal fixation.Repair of the PQ muscle was always recommended at the end of operation for some instructive reasons.But repair of PQ is not satisfied because of poor quality of muscle and fascial tissues which may cause pain or impede forearm pronation and supination for post-operative scarring around PQ.Inserting the locking palmar plate to pass under the pronator quadratus muscle and the locking screws are inserted through miniincisions in pronator quadratus in some patients with distal radius fractures is a reasonable technique which can preserve the pronator quadratus.The purpose of this study was to evaluate and compare the clinical effects after volar plating of the distal radius fractures while preserving the pronator quadratus and pronator quadratus repair.Methods Between September 2010 and April 2012,65 patients （42 males and 23 females; aged 20-68 years and a mean age of 42.5 years） with distal radius fracture underwent open reduction and internal fixation using the volar locking palmar plates （Depuy or Smith companies）.The patients were classified as 23A-2 through 23C-3 according to the Orthopaedic Trauma Association （OTA） classifications.All surgeries were completed by the same trained team.The volar locking palmar plates of distal radius performed with preserving pronator quadratus group involved 30 patients including 19 males and 11 females and performed with pronator quadratus repair group involved 35 patients including 23 males and 12 females.We compared the two groups for wrist pain,forearm range of motion,grip strength,pedoperative complications and wrist functional recovery score.Results The minimum follow-up for the whole cohort was one year.The differences between the two groups were significant with regard to wrist pain,forearm range of motion,grip strength and wrist function at 1,2,and 6 weeks postoperatively,but insi
文摘目的探讨腋窝入路肩胛盂前缘骨折复位固定的可行性及临床疗效。方法取两具新鲜成人大体标本(4侧肩关节),模拟经腋窝入路行肩胛盂前缘骨折切开复位内固定手术。标本置于侧卧位,于腋后线切开,经背阔肌前侧肌肉间隙显露肩胛骨侧方,分离并保护腋神经、旋肱后动脉、胸背神经及旋肩胛动脉等周围重要组织。腋窝入路下术野分为上侧"四边区"及下侧"三边区",可显露肩胛盂前下侧、肩胛颈及肩胛骨外侧缘全长。2018年4月至2020年12月采用腋窝入路肩胛盂切开复位内固定术治疗肩胛盂前缘骨折13例,男7例、女6例;年龄(50.38±13.74)岁(范围24~67岁);右肩12例、左肩1例,均为IdebergⅠa型骨折。采用解剖型支撑钢板固定5例、空心螺钉联合掌骨钢板固定7例、桡骨远端钢板固定1例。术后采用Constant-Murley评分、上肢功能评分(disabilities of the arm,shoulder and hand,DASH)评价临床疗效。结果全部病例均获得随访,随访时间(13.00±5.97)个月(范围6~26个月)。骨折均在6个月内愈合,无延迟愈合及畸形愈合。术后3个月Constant-Murley评分为(62.46±10.26)分(范围45~83分),DASH评分为(27.56±9.76)分(范围14.14~43.33分);术后6个月Constant-Murley评分为(80.85±8.32)分(范围65~90分),DASH评分为(11.47±8.56)分(范围0~35.00分);终末随访时Constant-Murley评分为(84.54±8.95)分(范围70~95分),DASH评分为(10.94±8.67)分(范围1.67~33.33分);随时间延长,关节功能逐渐恢复,术后3个月与术后6个月及末次随访时Constant-Murley评分和DASH评分的差异均有统计学意义(P<0.05)。结论腋窝入路是治疗肩胛骨前缘骨折安全、可行的入路;可显露肩胛盂前下侧和肩胛骨外侧缘,减少肩袖损伤,实现骨折解剖复位及坚强固定,并允许术后早期功能锻炼。
文摘Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years （mean 57 years）.Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen （AO） standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days （mean 5 days）.All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively （mean 22 months）.The fractures healed within 10-18 weeks after operation （mean 12 weeks）.During the last follow-up,the mean palmar tilt was （7.0±0.9）° and the mean ulnar variance was （21.0±4.2）°,showing significant difference when compared with preoperation （（-5.0±1.2）° and （8.0±3.8）°）.The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5%.Conclusions The clinical effect of distal radius fracture treated with open reduction and int
