Comparison of a single palmar lateral transverse approach versus the modified Henry approach in locking plate fixation of distal radius fractures
赵星 1刘鹏 1徐圣康 1张劲松 1罗斌 1熊为 1赵猛 1张以芳
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作者信息
1. 湖北省十堰市太和医院创伤骨科（湖北医药学院附属医院），湖北十堰 442000
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摘要
目的 比较单一掌侧横切口入路与改良Henry入路在锁定钢板固定治疗桡骨远端骨折中的疗效。 方法 回顾性分析2016年1月至2022年12月期间湖北省十堰市太和医院创伤骨科采用经单一掌侧横切口入路或改良Henry入路联合锁定钢板固定治疗的82例桡骨远端骨折患者资料。男25例，女57例；年龄（53.8±12.7）岁。按照手术切口不同，分为单一横切口组（n=42）和改良Henry组（n=40）。记录并比较患者致伤原因、受伤部位、受伤至手术时间、骨折AO分型、手术止血带时间、切口长度、骨折复位质量、末次随访时患者与观察者瘢痕评估量表（PSAS & OSAS）、末次随访时上肢功能评定表（DASH）评分及术后并发症情况等。 结果 两组患者的术前一般资料比较差异无统计学意义（P>0.05），有可比性。所有患者术后获（8.2±3.5）个月随访。随访期间单一横切口组1例出现正中神经掌皮支损伤，无感染、骨不连、内固定失效及肌腱损伤等其他并发症。单一横切口组切口长度[（2.4±0.9）cm]显著短于改良Henry组[（5.3±1.6）cm]；单一横切口组OSAS评分[（8.1±4.2）分]和PSAS评分[（10.1±5.8）分]均优于改良Henry组[（10.3±5.7）、（14.7±6.4）分]，以上项目两组之间差异均有统计学意义（P<0.05）。两组在止血带时间、骨折复位质量及末次随访时DASH评分方面差异均无统计学意义（P>0.05）。 结论 与改良Henry入路相比，单一掌侧横切口的微创入路在锁定钢板治疗桡骨远端骨折时更美观，且术后患者也可以迅速恢复工作和学习。 Objective To compare the clinical efficacy between a single palmar lateral transverse approach and the modified Henry approach in the locking plate fixation for distal radius fractures. Methods A retrospective study was conducted to analyze the data of 82 patients with distal radius fracture who had undergone locking plate fixation through either a single palmar lateral approach or the modified Henry approach between January 2016 and December 2022 at Department of Traumatic Orthopaedics, Taihe Hospital, Affiliated to Hubei University of Medicine. There were 25 males and 57 females, with an age of (53.8±12.7) years. Based on the difference in surgical approach, the patients were divided into a single transverse approach group (n=42) and a modified Henry approach group (n=40). The 2 groups were compared in terms of injury cause, injury location, time from injury to surgery, AO fracture classification, tourniquet time during surgery, incision length, fracture reduction, Patient and Observer Scar Assessment Scale (PSAS & OSAS) and Disability of the Arm, Shoulder, and Hand (DASH) score at the last follow-up, and complications after surgery. Results There were no statistically significant differences in the baseline characteristics between the 2 groups, indicating comparability (P>0.05). All patients were followed up for (8.2±3.5) months. Follow-ups revealed one case of injury to the palmar cutaneous branch of the median nerve but no other complications like infection, non-union, internal fixation failure, or tendon injury in the single transverse approach group. The single transverse approach group was significantly superior over the modified Henry approach group in incision length [(2.4±0.9) cm versus (5.3±1.6) cm], OSAS (8.1±4.2 versus 10.3±5.7), and PSAS (10.1±5.8 versus 14.7±6.4) (P<0.05). There were no significant differences between the 2 groups in tourniquet time, fracture reduction quality, and DASH score at the last follow-up (P>0.05). Conclusion In locking plate fixation for distal radius fractures, in comparison with the modified Henry approach, a single palmar lateral approach is more minimally invasive so that more aesthetically pleasing outcomes can be achieved to facilitate patients' rapid return to work and society.
Abstract
Objective To compare the clinical efficacy between a single palmar lateral transverse approach and the modified Henry approach in the locking plate fixation for distal radius fractures. Methods A retrospective study was conducted to analyze the data of 82 patients with distal radius fracture who had undergone locking plate fixation through either a single palmar lateral approach or the modified Henry approach between January 2016 and December 2022 at Department of Traumatic Orthopaedics, Taihe Hospital, Affiliated to Hubei University of Medicine. There were 25 males and 57 females, with an age of (53.8±12.7) years. Based on the difference in surgical approach, the patients were divided into a single transverse approach group (n=42) and a modified Henry approach group (n=40). The 2 groups were compared in terms of injury cause, injury location, time from injury to surgery, AO fracture classification, tourniquet time during surgery, incision length, fracture reduction, Patient and Observer Scar Assessment Scale (PSAS & OSAS) and Disability of the Arm, Shoulder, and Hand (DASH) score at the last follow-up, and complications after surgery. Results There were no statistically significant differences in the baseline characteristics between the 2 groups, indicating comparability (P>0.05). All patients were followed up for (8.2±3.5) months. Follow-ups revealed one case of injury to the palmar cutaneous branch of the median nerve but no other complications like infection, non-union, internal fixation failure, or tendon injury in the single transverse approach group. The single transverse approach group was significantly superior over the modified Henry approach group in incision length [(2.4±0.9) cm versus (5.3±1.6) cm], OSAS (8.1±4.2 versus 10.3±5.7), and PSAS (10.1±5.8 versus 14.7±6.4) (P<0.05). There were no significant differences between the 2 groups in tourniquet time, fracture reduction quality, and DASH score at the last follow-up (P>0.05). Conclusion In locking plate fixation for distal radius fractures, in comparison with the modified Henry approach, a single palmar lateral approach is more minimally invasive so that more aesthetically pleasing outcomes can be achieved to facilitate patients' rapid return to work and society.
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