改良Henry入路Acu-Loc掌侧锁定骨板系统治疗复杂型桡骨远端骨折的疗效分析
发布时间：2019-07-02 19:35
【摘要】：目的:通过回顾性分析分别经改良Henry入路和传统Henry入路结合Acu-Loc掌侧锁定骨板系统治疗复杂型桡骨远端骨折的临床效果,旨在探讨改良后的Henry入路和Acu-Loc掌侧锁定骨板系统在治疗桡骨远端不稳定性骨折的手术优势和术后疗效,为进一步提高不稳定型桡骨远端骨折的诊治质量提供理论依据。方法:选取2014年4月-2016年6月间由吉林大学中日联谊医院骨科接诊并最终行手术治疗的50例桡骨远端不稳定性骨折患者,按乱数表法将患者随机分为改良Henry入路组和传统Henry入路组,每组各25例患者,改良Henry入路组采用改良后的Henry手术入路结合Acu-Loc掌侧锁定骨板系统治疗;传统Henry入路组采用传统的Henry手术入路结合Acu-Loc掌侧锁定骨板系统治疗。术后均定期复查患侧腕关节正侧位X线片,观察桡骨远端关节面并测量掌倾角、尺偏角及桡骨短缩数值与术前对比,分别对照改良的Mcbride腕关节功能评估标准及Dienst腕关节功能评估标准,评价手术后患侧腕关节的功能恢复情况,并记录术中情况和术后并发症等。将所得数据进行统计学处理,以α=0.05为检验水准,P0.05差异有统计学意义。比较两组间的临床疗效和各组内手术前后的差异。结果:术后所有患者切口都甲级愈合,均配合随访,随访时间6-24个月,平均随访时间为(11.7士4.8)个月。术后半年,拍摄X线片结果显示,两组患者手术后的桡骨远端关节面均较为平整,桡骨无明显轴向短缩,内植物位置良好、未发现内固定物折断、无创伤性关节炎、无骨折延期愈合或骨折不愈合发生。两组患者与术前相比均获得了有效的治疗。腕关节功能评分及优良率方面,改良Henry入路组Dienst腕关节功能评估的优良率为96.00%(24/25),略高于传统Henry入路组的92.00%(23/25),但差异无统计学意义(P0.05);改良Henry入路组对照改良Mcbride腕关节功能评估标准的优良率为96.00%(24/25),而传统Henry入路组为92.00%(23/25),改良组仍高于传统组,但差异无统计学意义(P0.05)。在解剖角度方面,两组术后的掌倾角、尺偏角及桡骨高度无明显差异(P0.05);术后两组内的掌倾角、尺偏角及桡骨高度均较术前有明显改善(P0.05),差异有统计学意义。术中情况,改良Henry入路组与传统Henry入路组相比,前者的手术用时和骨折愈合周期均较短,且术中旋前方肌修复率高,术后正中神经刺激率低,差异均有统计学意义。结论:Acu-Loc桡骨远端掌侧锁定骨板系统治疗复杂型桡骨远端骨折,术中操作更加灵活便捷,骨折复位满意,固定牢靠,有效缩短手术时间,术后腕关节功能恢复良好,允许患肢早期从事轻度日常活动;改良Henry入路和传统Henry入路均能有效显露骨折,利于术中操作并有足够空间安置钢板,但改良Henry入路对旋前方肌损伤小,在使用相同内固定物的情况下,其术后相关并发症发生率低,患者良性主观回馈率高,值得在临床上进一步推广使用。
[Abstract]:Objective: to analyze the clinical effect of modified Henry approach and traditional Henry approach combined with Acu-Loc metacarpal locking bone plate system in the treatment of complex distal radius fractures. The purpose of this study was to investigate the surgical advantages and postoperative efficacy of modified Henry approach and Acu-Loc metacarpal locking bone plate system in the treatment of unstable distal radius fractures, and to provide theoretical basis for further improving the quality of diagnosis and treatment of unstable distal radius fractures. Methods: from April 2014 to June 2016, 50 patients with unstable distal radius fractures were randomly divided into modified Henry approach group (n = 25) and traditional Henry approach group (n = 25). The modified Henry approach group was treated with modified Henry approach combined with Acu-Loc palmally locked bone plate system. The traditional Henry approach group was treated with traditional Henry approach combined with Acu-Loc palmally locked bone plate system. The anterior and lateral radiographs of the affected wrist were reviewed regularly after operation. The distal radius joint surface was observed and the metacarpal inclination angle, ulna deviation angle and radius shortening were measured compared with those before operation. The improved Mcbride wrist joint function evaluation standard and Dienst wrist joint function evaluation standard were compared, and the functional recovery of the affected wrist joint after operation was evaluated, and the intraoperative situation and postoperative complications were recorded. The data were statistically processed, and 伪 = 0.05 was used as the test level, and the difference was statistically significant (P 0.05). The clinical efficacy of the two groups and the difference between the two groups before and after operation were compared. Results: all the incisions healed in grade A after operation, and all of them were followed up for 6 to 24 months, with an average follow-up time of (11.7 卤4.8) months. Half a year after operation, the results of X-ray film showed that the distal radius joint surface of the two groups was smooth, there was no obvious axial shortening of radius, the position of internal plant was good, no internal fixation was broken, no traumatic arthritis was found, and no delayed union or nonunion of fracture occurred. Both groups received effective treatment compared with preoperative treatment. In terms of wrist function score and excellent and good rate, the excellent and good rate of Dienst wrist function evaluation in modified Henry approach group was 96.00% (24 鈮，
本文编号：2509172
[Abstract]:Objective: to analyze the clinical effect of modified Henry approach and traditional Henry approach combined with Acu-Loc metacarpal locking bone plate system in the treatment of complex distal radius fractures. The purpose of this study was to investigate the surgical advantages and postoperative efficacy of modified Henry approach and Acu-Loc metacarpal locking bone plate system in the treatment of unstable distal radius fractures, and to provide theoretical basis for further improving the quality of diagnosis and treatment of unstable distal radius fractures. Methods: from April 2014 to June 2016, 50 patients with unstable distal radius fractures were randomly divided into modified Henry approach group (n = 25) and traditional Henry approach group (n = 25). The modified Henry approach group was treated with modified Henry approach combined with Acu-Loc palmally locked bone plate system. The traditional Henry approach group was treated with traditional Henry approach combined with Acu-Loc palmally locked bone plate system. The anterior and lateral radiographs of the affected wrist were reviewed regularly after operation. The distal radius joint surface was observed and the metacarpal inclination angle, ulna deviation angle and radius shortening were measured compared with those before operation. The improved Mcbride wrist joint function evaluation standard and Dienst wrist joint function evaluation standard were compared, and the functional recovery of the affected wrist joint after operation was evaluated, and the intraoperative situation and postoperative complications were recorded. The data were statistically processed, and 伪 = 0.05 was used as the test level, and the difference was statistically significant (P 0.05). The clinical efficacy of the two groups and the difference between the two groups before and after operation were compared. Results: all the incisions healed in grade A after operation, and all of them were followed up for 6 to 24 months, with an average follow-up time of (11.7 卤4.8) months. Half a year after operation, the results of X-ray film showed that the distal radius joint surface of the two groups was smooth, there was no obvious axial shortening of radius, the position of internal plant was good, no internal fixation was broken, no traumatic arthritis was found, and no delayed union or nonunion of fracture occurred. Both groups received effective treatment compared with preoperative treatment. In terms of wrist function score and excellent and good rate, the excellent and good rate of Dienst wrist function evaluation in modified Henry approach group was 96.00% (24 鈮，
本文编号：2509172
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