Chen Ju-Kun, Luo Yi-Wen, Huang Li-Ping
Department of Orthopaedics, Shangyu People's Hospital of Shaoxing, Shaoxing 312300, Zhejiang, China.
Zhongguo Gu Shang. 2024 Oct 25;37(10):959-64. doi: 10.12200/j.issn.1003-0034.20230464.
To investigate the clinical effect in treating AO type B and C distal radius fractures with modified Henry approach.
Retrospectively analysis of 20 patients with AO type B and C distal radius fractures between June 2021 and May 2022, they were treated by modified Henry approach. There were 6 males and 14 females, aged from 35 to 78 years old, 8 patients on the left and 12 on the right. The patients' general data, fracture healing time, postoperative complications, last-time follow up radiographic parameters(volar inclination angle, ulnar deviation angle and radius height), wrist range of motion, range of forearm rotation and functional outcoming of the wrist joint according to Mayo scoring were observed of each patient.
All patients were followed-up, the time was (13.3±2.3) months, ranged from 12 to 18 months. All the fractures were healed, the fracture healing time was (12.6±2.5) weeks, ranged from 10 to 16 weeks. There were no complications such as poor wound healing, incision infection, iatrogenic median nerve injury, delayed union, nonunion and malunion during the postoperative follow up. According to the X-ray measurement in the last-time follow up, the volar inclination angle was (11.4±4.0) °, the ulnar deviation angle was (20.9±2.2) ° and the radius height was (10.3±1.2) mm. The wrist range of motion was (65.3±5.8) ° for volar flexion, (60.2±4.2) ° for dorsal extension, (37.8±4.1) ° for ulnar deviation, (27.0±3.7) ° for radial deviation. The range of forearm rotation was(80.4±4.1) ° for pronation, (78.6±3.7) ° for supination. According to Mayo scoring, the wrist function was evaluated as excellent in 12 cases, good in 6 cases and fair in 2 cases, the excellent and good rate was 90%.
Modified Henry approach can better expose the ulnar and volar fragments in distal radius, especially useful for reducting the distal radius with complex bi-columnar fractures.
探讨改良亨利入路治疗AO B型和C型桡骨远端骨折的临床效果。
回顾性分析2021年6月至2022年5月间采用改良亨利入路治疗的20例AO B型和C型桡骨远端骨折患者。其中男性6例，女性14例，年龄35至78岁，左侧8例，右侧12例。观察每位患者的一般资料、骨折愈合时间、术后并发症、末次随访时的影像学参数（掌倾角、尺偏角和桡骨高度）、腕关节活动范围、前臂旋转范围以及根据梅奥评分法评估的腕关节功能结局。
所有患者均获随访，时间为（13.3±2.3）个月，范围为12至18个月。所有骨折均愈合，骨折愈合时间为（12.6±2.5）周，范围为10至16周。术后随访期间未出现伤口愈合不良、切口感染、医源性正中神经损伤、延迟愈合、不愈合及畸形愈合等并发症。末次随访时X线测量显示，掌倾角为（11.4±4.0）°，尺偏角为（20.9±2.2）°，桡骨高度为（10.3±1.2）mm。腕关节活动范围为掌屈（65.3±5.8）°、背伸（60.2±4.2）°、尺偏（37.8±4.1）°、桡偏（27.0±3.7）°。前臂旋转范围为旋前（80.4±4.1）°、旋后（78.6±3.7）°。根据梅奥评分法，腕关节功能评定为优12例，良6例，可2例，优良率为90%。
改良亨利入路能更好地显露桡骨远端的尺侧和掌侧骨折块，尤其适用于复杂双柱骨折的桡骨远端复位。
