VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA.
VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA.
J Hand Surg Am. 2023 May;48(5):516.e1-516.e5. doi: 10.1016/j.jhsa.2022.09.018. Epub 2023 Feb 21.
The number of distal radius fractures treated surgically is increasing, with the volar Henry approach most commonly used. Traditionally, to directly visualize intra-articular fracture reductions, a dorsal approach is also used, which can lead to increased morbidity and operative time. We describe the volar intra-articular extended window approach for intra-articular distal radius fractures, which allows direct visualization of fracture reduction from the same volar approach to the distal radius. The volar intra-articular extended window approach is performed by creating a capsulotomy in the volar wrist capsule between the long and short radiolunate ligaments while maintaining the integrity of the short radiolunate ligament to prevent postoperative carpal instability. Using this approach allows the surgeon to directly visualize the radiocarpal joint to assess reduction and ensure that no screws are placed intra-articular.
接受手术治疗的桡骨远端骨折数量正在增加，其中掌侧 Henry 入路最为常用。传统上，为了直接观察关节内骨折复位，还会采用背侧入路，但这会增加发病率和手术时间。我们介绍了一种用于关节内桡骨远端骨折的掌侧关节内扩展窗口入路，该入路可通过同一掌侧入路直接观察到骨折复位。掌侧关节内扩展窗口入路通过在长短桡侧腕韧带之间的掌侧腕关节囊上做一个囊切开术来完成，同时保持短桡侧腕韧带的完整性，以防止术后腕骨不稳定。使用这种方法可以让外科医生直接观察桡腕关节，评估复位情况，并确保没有螺钉进入关节内。
