| Objective To compare the effect of two different volar approaches with pronator anterior muscle in the treatment of distal radius fractures.Methods A retrospective analysis was performed on 30 patients with distal radius fractures who met the criteria at Wuhan Pu'ai Hospital,Tongji Medical College,Huazhong University of Science and Technology from October 2017 to October 2018.They were randomly divided into a control group and a test group,each group having15 For example,in the experimental group,anterior and posterior conservator muscles were used to make longitudinal and transverse small incisions at the proximal and distal ends of the fracture line(MIPPO approach).In the control group,an anterior conservator Henry incision was used.The palm side steel plate was placed in order to fix the screw.Both groups were treated with routine rehabilitation exercises and Huoxue Quyu Tongluo traditional Chinese medicine Xunxifang after 2 weeks(0.5 month),6 weeks(1.5month),12 weeks(3 month)and 24 Visual analogue pain score(VAS),wrist functional activity(Cooney score)at week(6th month)and overall efficacy observation at 24 weeks(6th month)after operation,collect wrist function data and conduct statistical research.Results All the 30 patients with distal radius fractures included in the study completed the follow-up observation for 24 weeks(6months).(1)Compare the sex,age,injury-side distribution,and AO classification distribution of patients in the test group with those in the control group.P> 0.05,and the difference was not statistically significant.(2)In terms of visual analogue pain score(VAS): after 2 weeks,the test group and the control group were compared,and the difference was not statistically significant(P> 0.05);There was a statistically significant difference between the two groups(P <0.05);the visual analgesic pain score(VAS)after treatment was compared between the two groups after 12 weeks and 24 weeks after the reduction of the anterior rotator muscle incision and the difference was not statistically significant(P>0.05).(3)In terms of wrist mobility(including palmar flexion,dorsiflexion,adduction,abduction,rotation): Comparison of two groups after anterior reduction of anterior rotator muscle reduction and reduction,there was no significant difference in the mobility of the wrist in all directions(P > 0.05);the two groups had statistically significant differences in the mobility of the wrist joints at 6 weeks and 12 weeks after surgery(P <0.05);the two groups were treated with anterior spiral muscle reduction and reduction after surgery 24 Weekly comparison,there was no significant difference in the activity of the wrist joint in all directions(P> 0.05).(4)In terms of wrist joint activity(Cooney)score: there was no significant difference between the two groups after anterior rotator muscle reduction and reduction at 2 weeks(P> 0.05);6 weeks,12 weeks,24 weeks Weekly comparison,the difference between the two groups was statistically significant(P<0.05).(5)Compare the curative effect of 24 weeks after anterior reduction of the anterior rotator muscle.The effective rate in the experimental group was 100%,and the effective rate in the control group was 93.6%.The difference was statistically significant(P<0.05).Conclusion The palmar MIPPO approach preserves the anterior rotator muscle for treatment of distal radius fractures.The use of the palmar Henry approach retains the anterior rotator muscle for treatment of distal radius fractures.In terms of recovery,the curative effect is better,the surgical scar is smaller,and the patient is more satisfied with the wrist function,appearance,and daily living ability.Huoxue Quyu Tongluo Xunxiu Fang has the effects of activating blood circulation,dissolving blood stasis and relieving pain,and reducing soft tissue adhesions after surgery,which has promoted the rehabilitation and functional recovery of the wrist after distal radius fracture incision and internal fixation.It is worth using in clinical promotion. |
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