Clinical Analysis Of Anatomical Locking Plate With Preserved Pronator Muscle In The Treatment Of Unstable Distal Radius Fractures

Objective To compare the efficacy of the pronator quadratus muscle preserved anatomical locking plate with the traditional method of open fixation and pronator quadratus muscle repair in the treatment of unstable distal radius fractures.Method A total of 44 patients with unstable distal radius fractures admitted to the First Affiliated Hospital of Xinjiang Medical University and its Changji Branch from September 2020 to April 2022 were prospectively included in this study.There were 18 males and 26 females,aged from 22 to 82 years,with an average age of 48.2 years.The causes of injury were falls in 26 cases and traffic accidents in 18 cases.The patients were divided into two groups according to the random number table.The 22 patients in the observation group were treated with locking plate placed under the volar pronator quadratus muscle for unstable distal radius fractures,and the 22 patients in the control group were treated with traditional incision and repair of the pronator quadratus muscle combined with locking plate.The operation time and intraoperative blood loss were observed in the two groups.X-ray films were taken at 3 months after operation to determine the fracture healing(radial height,palmar inclination Angle,and ulnar inclination Angle).The visual analogue scale(VAS)of wrist pain was compared between the two groups at 1 week,1 month and 3months after operation.The wrist joint function was evaluated by Dienst score,and the postoperative complications(flexor tendon irritation,carpal tunnel syndrome,joint stiffness)were observed and recorded.Result All the patients were followed.All the incisions healed well without infection or necrosis.The wrist joint imaging examination showed that the distal radius height,palmar inclination Angle,and ulnar inclination Angle were in the normal range.There was no articular surface collapse,and the fracture healing was good.There was no significant difference between the two groups(P> 0.05).The intraoperative blood loss and operation time of the observation group were less than those of the control group,and the differences were statistically significant(P< 0.05).The recovery of wrist joint function was evaluated by Dienst score,and the excellent and good rate was 95.45% in the observation group and 90.91% in the control group,and the difference was not statistically significant(P> 0.05).The difference in visual analogue scale(VAS)between the observation group and the control group was statistically significant(P< 0.05).There was significant difference in the incidence of flexor tendon irritation or rupture between the observation group and the control group(P < 0.05).There was no significant difference in the incidence of carpal tunnel syndrome and joint stiffness between the observation group and the control group,(P > 0.05).Conclusion Pronator quadratus muscle preservation with anatomical locking plate for unstable distal radius fractures can preserve the integrity of the pronator quadratus muscle,shorten the intraoperative blood loss,shorten the operation time,reduce the short-term postoperative pain and reduce the incidence of some complications,which is worthy of clinical application.