Clinical Research Of Unstable Radial Fractures With Wrist Palmar Double Channel Approach Locking Compression Plate Reserving Part Of Pronator Quadratus

Objective: To report treatment results of unstable radial fractures with wrist palmar double channel approach locking compression plate reserving part of pronator quadratus.Methods: From January 2014 to December 2016,109 cases of unstable radial fractures were treated with wrist palmar double channel approachlocking compression plate,part of pronator quadratus was reserved in the operation,the operation time and intraoperative blood loss were recorded and the fracture healing was evaluated by imaging evaluation.The wrist functions were evaluated by Gartland-Werley Scoring scale.Results : The average operation time was 60 minutes,ranged from 50 to 70 minutes,intraoperative blood loss was 15ml(10-20ml).These cases were follow-up for 12 to 36 months,average 20 months.Mean fracture healing time was 6 weeks(range from 4 to 8 weeks),with no fracture block displacement,internal fixation failure,locking plate and screw loosening or fracture,wound infection and so on.The wrist functions were evaluated by Gartland-Werley system only to find 89 excellent cases,18 good cases and 2 fair cases,with an excellent rate of 97 %.1 case of extensor hallucis longus tendon rupture 4 months postoperative,reconstructed the thumb extensor hallucis longus muscle tendon function by transplantation of palmaris longus tendon 12 months after the operation.Conclusions: The unstable radial fractures can effectively be treated with wrist palmar double channel approach locking compression plate.It could reduce the excessive dissection of the soft tissue,retain the anterior quadratus muscle,have fewer complications,faster healing of the fracture and better recovery of the wrist joint function.