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桡骨远端骨折固定期间肱桡肌松解对肘关节屈曲力量和腕关节功能的影响。

The effect of brachioradialis release during distal radius fracture fixation on elbow flexion strength and wrist function.

作者信息

Kim Jae Kwang, Park Jung Soo, Shin Sung Joon, Bae Hasuk, Kim So-yeon

机构信息

Departments of Orthopedic Surgery and Rehabilitation Medicine, Ewha Woman University, School of Medicine, Seoul, South Korea.

Departments of Orthopedic Surgery and Rehabilitation Medicine, Ewha Woman University, School of Medicine, Seoul, South Korea.

出版信息

J Hand Surg Am. 2014 Nov;39(11):2246-50. doi: 10.1016/j.jhsa.2014.07.043. Epub 2014 Sep 11.

Abstract

PURPOSE

To identify whether brachioradialis (BR) release during volar plate fixation for a distal radius fracture affects elbow flexion strength and wrist function.

METHODS

A total of 42 consecutive patients who were treated by open reduction volar plate fixation for unstable distal radius fractures were enrolled in this study. The BR was not released in 20 of 42 patients (BR preserved group) and was released in 22 patients (BR released group). The primary outcome variable was isokinetic strength and endurance testing of elbow flexion measured by the Cybex isokinetic system 3 months after surgery. Measured at the same time, secondary outcome variables were grip strength, a visual analog scale score for wrist pain, Disabilities of the Arm, Shoulder, and Hand score, and radiographic parameters. We used Mann-Whitney U tests to compare these variables between groups.

RESULTS

Neither elbow flexion strength and endurance nor any of the secondary outcome variables differed significantly between groups.

CONCLUSIONS

Release of the BR during a volar approach for a distal radius fracture did not adversely affect elbow flexion strength and wrist function.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.

摘要

目的

确定桡骨远端骨折掌侧钢板固定时肱桡肌(BR)的松解是否会影响肘关节屈曲力量和腕关节功能。

方法

本研究共纳入42例因不稳定桡骨远端骨折接受切开复位掌侧钢板固定治疗的连续患者。42例患者中,20例未松解肱桡肌(肱桡肌保留组),22例进行了肱桡肌松解(肱桡肌松解组)。主要观察指标为术后3个月使用Cybex等速系统测量的肘关节屈曲等速力量和耐力测试。同时测量的次要观察指标包括握力、腕部疼痛视觉模拟量表评分、上肢、肩部和手部功能障碍评分以及影像学参数。我们使用Mann-Whitney U检验比较两组之间的这些变量。

结果

两组之间的肘关节屈曲力量和耐力以及任何次要观察指标均无显著差异。

结论

桡骨远端骨折掌侧入路时肱桡肌的松解不会对肘关节屈曲力量和腕关节功能产生不利影响。

研究类型/证据水平:预后性III级。

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