| 特殊透视方法在掌侧锁定钢板治疗桡骨远端骨折中的临床应用 |
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投稿时间：2022-08-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 章荣 |
ZHANG Rong |
芜湖市第一人民医院骨科, 安徽 芜湖 241000 |
Department of Orthopaedics, the First People's Hospital of Wuhu, Wuhu 241000, Anhui, China |
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| 牛和明 |
NIU He-ming |
芜湖市第一人民医院骨科, 安徽 芜湖 241000 |
Department of Orthopaedics, the First People's Hospital of Wuhu, Wuhu 241000, Anhui, China |
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| 郭涛 |
GUO Tao |
芜湖市第一人民医院骨科, 安徽 芜湖 241000 |
Department of Orthopaedics, the First People's Hospital of Wuhu, Wuhu 241000, Anhui, China |
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| 解平锋 |
XIE Ping-feng |
芜湖市第一人民医院骨科, 安徽 芜湖 241000 |
Department of Orthopaedics, the First People's Hospital of Wuhu, Wuhu 241000, Anhui, China |
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| 吴加明 |
WU Jia-ming |
芜湖市第一人民医院骨科, 安徽 芜湖 241000 |
Department of Orthopaedics, the First People's Hospital of Wuhu, Wuhu 241000, Anhui, China |
609450460@qq.com |
| 谢加兵 |
XIE Jia-bing |
皖南医学院附属弋矶山医院创伤骨科, 安徽 芜湖 241001) |
Department of Orthopaedic Trauma, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 王林 |
WANG Lin |
皖南医学院附属弋矶山医院创伤骨科, 安徽 芜湖 241001) |
Department of Orthopaedic Trauma, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第2期，第128-132页 |
| DOI：10.12200/j.issn.1003-0034.2023.02.007 |
| 基金项目:安徽省自然科学基金(编号:1708085QH208);皖南医学院重点培育基金项目(编号:WK2020ZF20) |
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中文摘要:
目的：通过术中附加透视拍摄侧斜位X线片观察桡骨远端螺钉与腕关节面关系及腕背切线位X线片观察远端螺钉是否穿出背侧皮质,从而评价掌侧锁定钢板治疗桡骨远端骨折的临床疗效。
方法：自2020年1月至2021年6月,手术采用掌侧Henry入路治疗新鲜桡骨远端骨折45例,其中男20例,女25例,年龄32~75(52.4±8.1)岁。术中根据不同透视方法分为两组:对照组20例,为单纯透视拍摄标准正侧位X线片;观察组25例,在透视拍摄标准正侧位X线片基础上附加透视拍摄侧斜位X线片及腕背切线位X线片。观察两组术后6周及3、6个月腕关节功能评分和术后并发症发生情况。
结果：45例患者均获得随访,时间为6~14(10.8±1.7)个月,患者切口愈合良好,均获得骨性愈合。观察组并发症发生率低于对照组(P<0.05)。腕关节功能Gartland-Werley评分,观察组术后6周(4.58±1.31)分、3个月(2.98±0.63)分、6个月(1.95±0.65)分,均优于对照组术后6周(6.32±1.96)分、3个月(3.63±0.76)分、6个月(2.43±0.73)分,差异具有统计学意义(P<0.05)。观察组25例患者,术中通过加摄侧斜位X线片及腕背切线位X线片透视发现问题7例,阳性率为28%。
结论：术中附加透视拍摄侧斜位X线片及腕背切线位X线片,可以提高远端螺钉置入的准确性,减少术后并发症的发生,实现早期功能锻炼,有利于腕关节功能恢复。 |
| 【关键词】桡骨远端骨折 掌侧入路 锁定钢板 透视方法 |
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| Clinical application of special fluoroscopy method in the treatment of distal radius fractures with volar locking plate |
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ABSTRACT
Objective The relationship between the distal screws and the wrist articular surface was assessed by the additional lateral oblique fluoroscopic view during the operation,and the dorsal tangential view of the wrist was used to observe whether the distal screw penetrated the dorsal cortex,so as to evaluate the clinical efficacy of the volar locking plate in the treatment of distal radius fractures.
Methods From January 2020 to June 2021,45 cases of fresh distal radius fractures were treated using the volar Henry's approach,including 20 males and 25 females,aged from 32 to 75 years old with an average of (52.4±8.1) years old.During the operation,they were divided into 2 groups according to the different intraoperative fluoroscopic views:the control group of 20 cases,treated with standard anteroposterior and lateral fluoroscopic view;25 cases in the observation group,additional lateral oblique fluoroscopic view and dorsal tangential view of the wrist were taken.The wrist joint function score and postoperative complications were evaluated at 6 weeks,3 and 6 months after operation between two groups.
Results All 45 patients were followed up and the duration ranged from 6 to 14 months,with an average of (10.8±1.7) months,all patients achieved bone union and the incision healed well.The incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant (P<0.05).In terms of Gartland-Werley score of wrist joint function,the score of wrist function in the observation group was (4.58±1.31) at 6 weeks,(2.98±0.63) at 3 months and (1.95±0.65) at 6 months post-operatively,which were better than those in the control group (6.32±1.96) at 6 weeks,(3.63±0.76) at 3 months and (2.43±0.73) at 6 months.The difference was statistically significant (P<0.05).In the observation group,7/25 cases (28%) were found to have screw penetration during the operation by additional lateral oblique and dorsal tangential radiograph fluoroscopic views of wrist.
Conclusion The addition of lateral oblique and dorsal tangential during the operation could improve the accuracy of distal screw placement,reduce postoperative complications,and achieve early functional exercise. |
| KEY WORDS Distal radius fracture Volar approach Locking plate Fluoroscopic views |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 章荣,牛和明,郭涛,解平锋,吴加明,谢加兵,王林.特殊透视方法在掌侧锁定钢板治疗桡骨远端骨折中的临床应用[J].中国骨伤,2023,36(2):128~132 |
| 英文格式: | ZHANG Rong,NIU He-ming,GUO Tao,XIE Ping-feng,WU Jia-ming,XIE Jia-bing,WANG Lin.Clinical application of special fluoroscopy method in the treatment of distal radius fractures with volar locking plate[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(2):128~132 |
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