Treatment of complicated intra-articular distal radius fractures with extended flexor carpi radialis approach / 北京大学学报(医学版)

ABSTRACT

Objective:To discuss the effect of treatment of complicated intra-articular distal radius fractures with extended flexor carpi radialis approach.Methods: A retrospective analysis of 38 cases with fresh complicated intra-articular distal radius fractures treated by using extended flexor carpi radialis approach in our hospital from October 2012 to March 2015,with 25 males and 13 females.The average age was (52.76±8.62) years (32-64 years).The average time to surgery was (5.42±1.91) d (3-10 d),with left wrist 17 cases and right wrist 21 cases.All the patients were with C3 distal radius fractures according to Association for the Study of Internal Fixation (AO/ASIF) classification.The follow-up was conducted 1,2,3,6,and 12 months after operation,including AP and lateral X-ray,wrist extension and flexion,radial deviation and ulnar deviation,forearm pronation and supination,and grip strength.At the end of 6 and 12 months after operation,all the patients were evaluated by using the mo-dified Garland-Werley score and patient rated wrist evaluation (PRWE).Results: All the patients got good bone union,and their follow-up time was more than 12 months.The average follow-up time was (16.37±2.85) months (12-22 months).The score of modified Garland-Werley evaluation 6 months post-operation was 5.37±2.82,excellent and good rate was 84.21％,the score of modified Garland-Werley evaluation 12 months post-operation was 5.03±2.60,excellent and good rate was 86.84％.The score of PRWE 6 months post-operation was 15.82±8.38,the score of PRWE 12 months post-operation was 12.17±7.58.Conclusion: The extended flexor carpi radialis approach is effective for the treatment of complicated intra-articular distal radius fractures and can avoid the complications of volar and dorsal combination approach.