The clinical effect of different anterior rotator muscle treatment methods in the Henry approach on the treatment of distal radius fractures
Henry入路中不同旋前方肌处理方法对治疗桡骨远端骨折的临床效果

摘要

目的 探讨Henry入路中旋前方肌原位保留缝合与切断后修复两种处理方法在桡骨远端骨折治疗中的临床效果差异，为临床术式选择提供循证参考。方法 选取我院骨科2023年1月-2024年12月收治的80例桡骨远端骨折患者作为研究对象，均采用Henry入路手术治疗，按照旋前方肌处理方式的不同分为观察组（40例，旋前方肌肌腹-腱止点复合体保护性潜行剥离复位固定术）与对照组（40例，常规旋前方肌离断后重建修复）。对比两组患者的手术相关指标、骨折愈合情况、腕关节功能恢复程度及术后并发症发生率。结果 观察组术中出血量显著少于对照组，骨折愈合时间显著短于对照组，差异均有统计学意义（P<0.05）；对照组改良Mayo腕关节功能评分显著低于观察组，两组间差异达到统计学判定标准（P<0.05）；观察组术后各类并发症的总体发生概率显著低于对照组，组间统计学差异显著（P<0.05；结论 对桡骨远端骨折患者施以Henry入路手术方案施治时，对旋前方肌施以原位保留缝合的处置策略，既能削减术中侵袭性损伤，缩减骨折愈后周期，助推腕关节运动功能的重建与恢复，亦可降低术后不良事件的发生风险，其临床实用价值显著凌驾于肌腹切断再修复的传统术式之上。

Abstract

Objective To explore the differences in clinical effects between orthotopic preservation and suture of the anterior rotator muscle of the Henry approach and repair after incision in the treatment of distal radius fractures, and to provide evidence-based references for the selection of clinical surgical methods.
Methods 80 patients with distal radius fractures admitted to our orthopedic department from January 2023 to December 2024 were selected as the research subjects. They were all treated with Henry's approach surgery and divided into an observation group (40 cases, protective stealth dissection and reduction fixation of the pronator abdominis tendon insertion complex) and a control group (40 cases, conventional reconstruction and repair of the pronator muscle after dissection) according to the different treatment methods of the pronator muscle. Compare the surgical related indicators, fracture healing status, degree of wrist joint function recovery, and incidence of postoperative complications between two groups of patients.
Results The intraoperative bleeding in the observation group was significantly less than that in the control group, and the fracture healing time was significantly shorter than that in the control group, with statistically significant differences (P<0.05); The modified Mayo wrist joint function score of the control group was significantly lower than that of the observation group, and the difference between the two groups reached the statistical judgment standard (P<0.05); The overall probability of various postoperative complications in the observation group was significantly lower than that in the control group, and the statistical difference between the groups was significant (P<0.05).
Conclusion   When using the Henry approach surgical plan to treat patients with distal radius fractures, the treatment strategy of preserving and suturing the pronator muscle in situ can not only reduce invasive injuries during surgery, shorten the fracture recovery period, promote the reconstruction and recovery of wrist joint movement function, but also reduce the risk of postoperative adverse events. Its clinical practical value is significantly higher than that of traditional surgical methods such as myoabdominal cutting and reconstruction.