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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
顾锋,梁永辉,刘申,李新天,郭文杰,李青松,韦兴.保留旋前方肌掌侧微创入路治疗老年桡骨远端骨折的效果[J].中华老年多器官疾病杂志,2020,19(7):504~507
保留旋前方肌掌侧微创入路治疗老年桡骨远端骨折的效果
Curative effect of minimally invasive approach with preservation of palmar side of pronator quadratus in treatment of distal radius fracture in the elderly
投稿时间:2020-03-01  
DOI:10.11915/j.issn.1671-5403.2020.07.119
中文关键词:  老年人;旋前方肌;桡骨远端骨折;微创
英文关键词:aged; pronator quadratus muscle; distal radius fracture; minimal invasion Corresponding author:LIANG Yong-Hui, E-mail:13910199041@163.com〖FL
基金项目:
作者单位E-mail
顾锋 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
梁永辉 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
刘申 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
李新天 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
郭文杰 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
李青松 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
韦兴 航天中心医院骨科,北京 100049 13910199041@163.comcurative 
摘要点击次数: 33
全文下载次数: 28
中文摘要:
      目的 对比保留旋前方肌掌侧微创入路与传统Henry入路治疗老年桡骨远端骨折的临床疗效。方法 选取2016年1月至2019年1月在航天中心医院骨科住院治疗的老年桡骨远端骨折患者46例进行回顾性分析。依据治疗方法分为2组:微创组和对照组,每组各23例。微创组采取保留旋前方肌掌侧微创入路锁定钢板螺钉内固定术;对照组采取传统切开旋前方肌Henry掌侧入路钢板螺钉内固定术。比较2组患者手术切口长度、术中出血量、手术并发症、术后住院时间、骨折复位情况(掌倾角和尺偏角)及术后3个月腕关节功能恢复情况。采用SPSS 20.0软件进行数据处理。依据数据类型,组间比较采用t检验或χ2检验。结果 与对照组相比,微创组患者的切口长度[(2.4±0.3)和(7.2±1.4)cm]、术中出血量[(13.2±2.1)和(31.2±4.1)ml]和术后住院时间[(4.6±0.9)和(7.5±1.2)d]均显著减少(P<0.05)。2组患者术后均未发生手术并发症。微创组患者术后3个月的视觉模拟量表(VAS)评分显著低于对照组[(0.5±0.2)和(2.2±0.4)分,P<0.05],而Gartland-Werley评分达优率(95.65% 和73.91%)和腕关节旋前角度(83.8°±10.8° 和74.6°±9.5°)均显著高于对照组(P<0.05)。结论 保留旋前方肌掌侧微创入路钢板螺钉内固定治疗老年桡骨远端骨折的疗效较好,且手术切口小,术中出血量少,术后3个月腕关节整体功能恢复好。
英文摘要:
      Objective To compare the clinical efficacy of minimally invasive surgery with preservation of palmar side of pronator quadratus versus traditional Henry approach in the treatment of distal radius fractures in the elderly. Methods A retrospective study was carried out on 46 elderly patients with distal radius fracture treated in our department from January 2016 to January 2019. The patients were divided into minimally invasive group and control group, with 23 cases in each group. The minimally invasive group was treated by internal fixation with locking plate and screw and preservation of pronator quadratus, while the control group was treated with traditional open Henry volar approach of pronator quadratus muscle combined with internal fixation of plate and screw. The length of incision, intraoperative bleeding volume, complications, length of hospital stay, reduction of fracture and wrist joint function in 3 months after operation were compared between the two groups. SPSS statistics 20.0 was used to perform the statistical analysis. Student′st test or Chi-square test was employed in intergroup comparison for different data types. Results Compared with the control group, the incision length [(2.4±0.3) vs (7.2±1.4)cm] and the intraoperative bleeding volume [(13.2±2.1) vs (31.2±4.1)ml] were significantly less, and postoperative length of hospital stay [(4.6±0.9) vs (7.5±1.2)d] was obviously shorter in the minimally invasive group (P<0.05). No postoperative complications occurred in both groups. The visual analogue scale (VAS) scores of the patients were notably lower in the minimally invasive group than the control group [(0.5±0.2) vs (2.2±0.4), P<0.05], while the rates of the patients with better Gartland-Werley scores (95.65% vs 73.91%) and the wrist pronation angles [(83.8°±10.8°)vs (74.6°±9.5°)] were significantly larger in the former group than the latter group (P<0.05). Conclusion Minimally invasive surgery with preservation of palmar side of pronator quadratus and internal fixation with locking plate and screw exerts good efficacy in the treatment of distal radius fractures in the elderly, with small incision, less intraoperative bleeding, and sound overall wrist function in 3 months after operation.
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