掌侧与背侧入路治疗桡骨远端不稳定型骨折疗效比较

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Abstract Objective To study the clinical efficacy of the volar approach and the dorsal approach in the treatment of unstable fractures of distal radius. Methods Fifty-nine patients with unstable fractures of distal radius who were treated with open reduction and locking compression plate were selected from Tibet Autonomous Region Corps Hospital of Chinese People’s Armed Police Force from June 2016 to June 2021. According to the displacement trend of distal radius fractures, they were divided into the volar approach group (31 cases) and the dorsal approach group (28 cases). The postoperative palmar angle, radial height, ulnar angle, the incidence of early complications within 1 month after operation, the incidence of long-term complications within 6 months after operation, and the wrist function at 6 months after operation were compared between the two groups. Results There were no statistically significant differences in palmar tilt angle, radius height, ulnar angle, length of hospital stay or healing time between the two groups between the two groups (P＞0.05) . The operative time was shorter in volar approach group (85.50±11.21 min) than in dorsal approach group (94.75±15.55 min), the intraoperative bleeding volume was greater in volar approach group (125.54±28.78 ml) than in the dorsal approach group (110.78±25.71 ml), and the differences were statistically significant (P<0.05). In the comparison of recent complications 1 month after surgery, there were 4 cases of median nerve injury in volar approach group, which was more than that in the dorsal approach group, but the rate of tendon injury was lower than that in the dorsal approach group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of radial artery injury, incisional infection, or radial nerve injury between the two groups (P＞0.05). There was no significant difference in the 6-month long-term complication rate or the excellent and good recovery rate of wrist joint function between the two groups (P>0.05). Conclusions Different approaches based on different displacement trends can effectively treat unstable fractures of distal radius and regain stability of the wrist joint, which can obtain positive clinical outcomes.

Key words： unstable fracture of distal radius open reduction and internal fixation volar approach dorsal approach

Received: 30 December 2022

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	Articles by authors
	BAI Yongxin
	ZHOU Chao
	FAN Tianchang
	LIU Guicong
	HU Jun
	ZHOU Weishan

Cite this article:

BAI Yongxin,ZHOU Chao,FAN Tianchang等. Comparison of clinical efficacy of volar and dorsal approaches in treatment of unstable fractures of distal radius[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(7): 586-588.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2023/V34/I7/586

[1]	Ilyas A M. Surgical approaches to the distal radius[J]. Hand (N Y), 2011, 6(1): 8-17.
[2]	宗双乐. 桡骨远端骨折治疗的临床研究和荟萃分析[D]. 天津:天津医科大学, 2017.
[3]	李道选,王伟,李俊明,等. 不同入路方式下锁定钢板内固定治疗桡骨远端骨折的疗效及对腕关节功能的影响[J]. 四川解剖学杂志, 2020, 28(1): 63-64.
[4]	郑尤辉,郭颖彬,叶春晓,等. 桡骨远端骨折治疗的研究进展[J]. 中国民间疗法, 2020, 28(16): 112-115.
[5]	Cepeda I G, AguadoM I, De BlasS I, et al. Radiological results of surgical management of fracture of the distal radius treated with volar locking plates[J]. Injury, 2020, 51 Suppl 1S42-S47.
[6]	de George B R, Van Houten H K, Mwangi R,et al. Outcomes and complications of operative versus non-operative management of distal radius fractures in adults under 65 years of age[J]. J Hand Surg Eur Vol, 2021, 46(2): 159-166.
[7]	Yuan K,Wang F,Lu H. Analysis of postoperative complications and related factors affecting prognosis in 50 patients with distal radius fractures[J]. Evid Based Complement Alternat Med, 2021, 20218005945.
[8]	Jia Z,Wang S, Jiang W, et al. The treatment of complex intra-articular distal radius fractures with turning radius and distal volaris radius plate fixation[J]. Eur J Med Res, 2020, 25(1): 66.
[9]	Solasz S J,Moses M J,Egol K A.Partial articular fracture of the distal radius treated via dorsal approach[J]. J Orthop Trauma, 2022, 36(Suppl 3): S13-S14.
[10]	Jakubietz M G,Gruenert J G,Jakubietz R G. Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term?[J]. J Orthop Surg Res, 2012, 7(1): 8.
[11]	Beyer J, Wynkoop E, Liu J, et al. Interventions for distal radius fractures: a meta-analysis of comparison studies[J]. J Wrist Surg, 2021, 10(5): 440-457.
[12]	Liverneaux P A.New trends in distal radius fractures[J].Eur J Orthop Surg Traumatol, 2018, 28(8): 1457-1458.
[13]	王淼,韩智强.掌侧与背侧不同入路手术内固定治疗桡骨远端C型骨折的临床效果[J].现代医学与健康研究电子杂志, 2018, 2(12): 34.
[14]	康宝林,王东建,张鑫.掌侧与背侧入路切开复位内固定治疗C型桡骨远端骨折的比较研究[J].实用骨科杂志, 2016, 22(3): 272-274.
[15]	袁同乐.掌侧入路、背侧入路用于桡骨远端骨折的临床对照试验[J].临床研究, 2018, 26(12): 94-95.
[16]	杨能.影响桡骨远端骨折并发症发生的因素分析[D].长沙:中南大学, 2012.
[17]	Rein S, Schikore H, Schneiders W, et al. Results of dorsal or volar plate fixation of AO type C3 distal radius fractures: a retrospective study[J].J Hand Surg Am, 2007, 32(7): 954-961.
[18]	Eikrem M,Brannsten H, Bjorkoy D,et al.Volar locking plate versus dorsal locking nail-plate fixation for dorsally displaced unstable extra-articular distal radial fractures: functional and radiographic results from a randomized controlled trial[J]. JBJS Open Access, 2021, 6(4).
[19]	陶新. AO2.4mmLCP治疗桡骨极远端骨折的临床研究[D].苏州:苏州大学, 2018.
[20]	张屹,杨拓,李辉,等. 掌侧与背侧入路钢板置入固定修复桡骨远端骨折并发症的Meta分析[J].中国组织工程研究, 2014, 18(22): 3560-3566.

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