掌侧入路钢板内固定旋前方肌处理对桡骨骨折腕关节功能的影响

康健

[摘要] 目的 研究掌侧入路钢板内固定旋前方肌肉处理对桡骨骨折腕关节功能的影响。方法 方便选取2014年2月—2016年2月该院收治的90例桡骨骨折患者作为研究对象，随机抽签分为两组，各45例。观察组行掌侧入路钢板内固定旋前方肌处理，对照组采用背侧入路钢板内固定旋前方肌处理。比较两组围术期一般情况[手术时间、切口愈合时间、住院时间、尺偏角、掌倾角及桡骨高度]，记录两组患者术后腕关节恢复情况和并发症发生率。结果 观察组切口愈合和住院时间分别为（5.78±1.43）d和（8.02±1.34）d，均显著低于对照组（P<0.05）。两组术后1年腕关节功能优良率差异无统计学意义（P>0.05）。观察组术后并发症总发生率为8.89%，显著低于对照组，差异有统计学意义（P<0.05）。结论 掌背侧入路钢板内固定旋前方肌处理用于桡骨骨折均能获得良好的腕关节功能恢复效果，但掌侧入路术后并发症少，有助于患者早期恢复。

[关键词] 桡骨骨折；掌侧入路；内固定；腕关节

[中图分类号] R68 [文献标识码] A [文章编号] 1674-0742（2017）05（a）-0110-03

[Abstract] Objective To study the effect of volar plate fixationof anterior longitudinal muscle to the function of wrist joint in radial fracture. Methods 90 patients with distal radius fractures from February 2014 to February 2016 were enrolled in this study and randomly divided into two groups，45 cases in each group.In the observation group， the wrist joint of the radial fracture was treated with the internal fixation of the plate， and the control group was treated with the dorsal approach plate internal fixation and the anterior fissure.The general condition [operation time，wound healing time，hospitalization time，slip angle，palm inclination and radius height] were compared.The recovery of wrist joint and complication rate were recorded.Results The wound healing time and hospital stay in the observation group were [（5.78±1.43）and（8.02±1.34）]，which were significantly lower than those in the control group（P<0.05）.There was no significant difference between the two groups in the wrist function after operation for 1 years（P>0.05）. The incidence of postoperative complications in the observation group was 8.89%，that was significantly lower than that in the control group （P< 0.05）. Conclusion The volar and dorsal approach of internal fixation of the anterior radial muscle have the similar effect to recovery the wrist function of radial fractures.But there are few complications of volar approach， which is helpful for early recovery of patients.

[Key words] Radial fracture；Volar approach；Internal fixation；Wrist joint

桡骨骨折是常见的上肢骨折，桡骨骨折所造成的腕关节功能障碍对患者远期生活质量的影响日益引起临床重视[1]。内固定治疗方式在桡骨远端不稳定骨折中的应用价值已获得临床肯定[2]，但临床对手术入路的选择仍存在争议[3]。为此，该研究纳入该院2014年2月—2016年2月收治的90例桡骨骨折患者，对比分析掌侧入路与背侧入路两种入路方式对患者远期腕关节功能恢复的影响，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的90例桡骨骨折患者作为研究对象，随机抽签分为观察组和对照组，各45例。观察组男32例，女13例；年龄（46.95±10.32）岁；分型：A3型5例，B1型8例，B2型11例，B3型15例，C1型6例。桡骨缩短（4.52±0.43）mm；掌倾角（9.35±2.02）°；尺偏角（7.15±3.22）°。对照组男28例，女17例；年龄（47.11±9.98）岁；……