文章摘要

不同入路方式的钢板内固定术对尺桡骨中上段双骨折患者术后骨折愈合及功能恢复的影响

作者: 1李兴波, 1肖睿
1 宜宾市第一人民医院骨二科,四川 宜宾 644000
通讯: 李兴波 Email: 632352056@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.08.033

摘要

目的:研究不同入路方式的钢板内固定对尺桡骨中上段双骨折患者术后骨折愈合及功能恢复的影响。方法:将2015年6月至2017年2月在宜宾市第一人民医院进行手术治疗的97例尺桡骨中上段双骨折患者随机分为治疗A组(49例)与治疗B组(48例),两组患者入院均给予外伤处理、消肿等对症治疗。治疗A组手术经背侧单切口入路钢板内固定,治疗B组手术经桡尺侧双切口入路钢板内固定。比较两组临床疗效、手术时间、术中出血量、切口长度、骨折愈合时间及术后血清可溶性细胞间黏附分子1(soluble intercellular adhesion molecule 1,sICAM-1)、可溶性血管细胞黏附分子1(soluble vascular cell adhesion molecule 1,sVCAM-1)、白细胞介素10(interleukin 10,IL-10)及超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平,术后5 d采用VAS评分评估患者疼痛程度,术后2周及12周采用特种外科医院(Hospital for Special Surgery,HSS)评分评估患者前臂功能恢复情况。结果:两组优良率、手术时间、术中出血量、骨折愈合时间及术后12周HSS评分比较差异均无统计学意义(均P>0.05);治疗A组切口长度显著短于治疗B组,术后5 d VAS评分显著低于治疗B组,术后2周HSS评分显著高于治疗B组(均P<0.05);两组术后血清sICAM-1,sVCAM-1及IL-10,hs-CRP水平差异无统计学意义(均P>0.05);两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:与桡尺侧双切口钢板内固定相比,背侧单切口钢板内固定治疗尺桡骨中上段双骨折切口明显较小,术后患者疼痛程度明显减轻,前臂功能恢复较快。
关键词: 尺桡骨中上段双骨折;钢板内固定;骨折愈合;功能恢复

Effect of plate fixation with different approaches on postoperative fracture healing and functional recovery in patients with double fractures of the middle and upper radius

Authors: 1LI Xingbo, 1XIAO Rui
1 Second Department of Orthopedics, Yibin First People’s Hospital, Yibin Sichuan 644000, China

CorrespondingAuthor: LI Xingbo Email: 632352056@qq.com

DOI: 10.3978/j.issn.2095-6959.2020.08.033

Abstract

Objective: To investigate the effect of internal plate fixation with different approaches on postoperative fracture healing and functional recovery in patients with middle and upper ulnar fractures. Methods: A total of 97 patients with double upper and middle ulnar radius fractures who underwent surgical treatment in our hospital from June 2015 to February 2017 were randomly divided into treatment group 49 and group B 48. Both patients were treated with trauma after admission. Swelling and other symptomatic treatment, the treatment of group A was fixed by a dorsal single incision approach plate, and the treatment of group B was fixed by a radial and ulnar approach. The clinical efficacy, surgical time, intraoperative blood loss, incision length, fracture healing time, and serum soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule 1 (sVCAM-1) were compared between the two groups. Interleukin 10 (IL-10) and high-sensitivity C-reactive protein (hs-CRP) levels, 5 days after surgery, the patients were assessed for pain with a VAS score, and Hospital for Special Surgery (HSS) scores were used to assess the recovery of forearm function at 2 and 12 weeks Happening. Results: There was no significant difference in the excellent rate, operation time, intraoperative blood loss, fracture healing time, and HSS score of 12 weeks after operation in the two groups (all P>0.05). The length of the incision in group A was significantly shorter than that in group B. The dVAS score was significantly lower than that in treatment group B, and the HSS score was significantly higher than that in treatment group 2 at 2 weeks after operation (all P<0.05); there was no difference in serum sICAM-1, sVCAM-1, IL-10, and hs-CRP levels between the two groups (all P>0.05); there was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Compared with radial ulnar-side double incision plate internal fixation, dorsal single-incision plate internal fixation for the treatment of double-fracture fractures in the middle and upper segments of the ulnar and radial bone is significantly smaller. Postoperative pain is significantly reduced, and forearm function recovers faster.
Keywords: radioulnar middle and upper double fractures; internal fixation of steel plate; fracture healing; functional recovery