克氏针三点定位保留旋前方肌的微创钢板内固定术治疗桡骨远端骨折的临床疗效

doi:10.3969/j.issn.1671-7171.2022.03.006

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摘要【目的】探讨克氏针三点定位保留旋前方肌的微创钢板内固定术治疗桡骨远端骨折的临床效果。【方法】选取2018年7月至2021年7月岐山县医院收治的桡骨远端骨折患者118例,按照治疗方法不同分为对照组、观察组,每组59例。对照组采用常规保留旋前方肌的微创钢板内固定术治疗,观察组采用克氏针三点定位保留旋前方肌的微创钢板内固定术治疗。观察两组患者围术期指标(手术时间、术中出血量、旋前方肌下钢板调放次数、切口长度)和术后3个月临床效果。比较观察两组患者术后3个月腕关节活动度及术后1个月、术后3个月腕关节功能(Gartland Werley评分)、上肢功能(DASH评分)及其并发症。【结果】两组手术时间、术中出血量、切口长度、治疗效果优良率比较,差异无统计学意义(P>0.05);观察组旋前方肌下钢板调放次数少于对照组(P<0.05);术后3个月,观察组旋前角度、桡偏角度大于对照组(P<0.05);术后1个月、3个月,观察组Gartland Werley、DASH评分低于对照组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。【结论】克氏针三点定位保留旋前方肌的微创钢板内固定术治疗桡骨远端骨折能减少旋前方肌下钢板调放次数,提升腕关节活动度,改善腕关节功能及上肢功能,且安全性高,值得临床推广应用。

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	乔荣芳
	柯贤鹏

关键词 ：桡骨骨折/外科学, 骨折固定术,内, 骨板

Abstract：【Objective】To investigate the clinical effect of minimally invasive plate internal fixation with three-point Kirschner wire and preservation of pronator muscle in the treatment of distal radius fractures.【Methods】A total of 118 patients with distal radius fractures treated in Qishan County Hospital from July 2018 to July 2021 were selected and divided into control group and observation group according to different treatment methods, with 59 cases in each group. The control group was treated with conventional minimally invasive plate internal fixation with preservation of pronator muscle, and the observation group was treated with minimally invasive plate internal fixation with preservation of pronator muscle by three-point positioning of Kirschner wire. The perioperative indexes (operation time, intraoperative bleeding, number of times of anterior pronator submuscular plate adjustment, incision length) and the clinical effect of 3 months after operation were observed. The wrist range of motion, wrist function (Gartland Werley score), upper limb function (DASH score) and complications were compared and observed between the two groups at 3 months after operation. 【Results】There was no significant difference between the two groups in operation time, intraoperative bleeding, incision length and excellent rate of treatment effect (P>0.05); The number of adjustment and release of pronator submuscular plate in the observation group was less than that in the control group (P<0.05); Three months after operation, the pronation angle and radial deviation angle in the observation group were greater than those in the control group (P<0.05); At 1 and 3 months after operation, the Gartland Werley and DASH scores in the observation group were lower than those in the control group (P<0.05); There was no significant difference in the incidence of complications between the two groups (P>0.05). 【Conclusion】Kirschner wire three-point positioning and minimally invasive plate internal fixation with preservation of pronator muscle in the treatment of distal radius fractures can reduce the number of adjustment and placement of pronator muscle plate, improve wrist range of motion, improve wrist function and upper limb function, and has high safety, which is worthy of clinical application.

Key words： Radius Fractures/SU Fracture Fixation, Internal Bone Plates

收稿日期: 2021-12-31

中图分类号:

R683.415

通讯作者: * E-mail: 353696154@qq.com

引用本文:

乔荣芳, 柯贤鹏. 克氏针三点定位保留旋前方肌的微创钢板内固定术治疗桡骨远端骨折的临床疗效[J]. 医学临床研究, 2022, 39(3): 340-343.
QIAO Rong-fang, KE Xian-peng. Clinical Observation of Minimally Invasive Plate Internal Fixation with Three-point Positioning of Kirschner Wire and Preservation of Pronator Muscle in the Treatment of Distal Radius Fractures. JOURNAL OF CLINICAL RESEARCH, 2022, 39(3): 340-343.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.03.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I3/340

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