Comparison of palmar minimally invasive approach versus palmar traditional approach for locking plate implantation for distal radius fractures
10.3760/cma.j.cn115530-20240311-00111
- VernacularTitle:掌侧传统入路与掌侧单一切口微创入路置入锁定钢板固定治疗桡骨远端骨折的疗效比较
- Author:
Jun LIU
1
;
Yuan XUE
;
Peng WANG
;
Yongwei WU
;
Yongjun RUI
Author Information
1. 无锡市第九人民医院创伤骨科，无锡 214062
- Keywords:
Radius fractures;
Surgical procedures, minimally invasive;
Fracture fixation, internal;
Surgical approach
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(8):671-678
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the palmar minimally invasive approach by a single incision versus palmar traditional approach for implantation of a locking plate in the treatment of distal radius fractures.Methods:A retrospective analysis was conducted of the 116 patients with distal radius fracture who had been treated with locking plates implanted through a palmar approach at Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital from January 2019 to December 2022. There were 51 males and 65 females aged (57.0±10.6) years. According to the difference in palmar approach, they were divided into a traditional group of 65 cases treated with a traditional palmar approach and a minimally invasive group of 51 cases treated with a minimally invasive palmar approach through a single 1.5 cm incision. The surgical time, intraoperative bleeding, incision length, incision healing, fracture healing time, pain visual analogue scale (VAS) on the 1st and 7th days after surgery, range of motion and grip strength of the affected wrist, and imaging results at the last follow-up were recorded and compared between the 2 groups. The patient rated wrist evaluation (PRWE) and Gartland-Werley wrist evaluation were used to assess functional recovery of the wrist affected at the last follow-up.Results:There was no statistically significant difference in the baseline data between the 2 groups, indicating comparability ( P>0.05). All patients were followed-up for (13.6±2.1) months. All fractures healed. The intraoperative bleeding [(27.3±3.6) mL] in the minimally invasive group was significantly less than that in the traditional group [(41.2±6.8) mL], the incision length [(1.6±0.1) cm] in the former was significantly shorter than that in latter [(6.6 ± 0.6) cm], the postoperative VAS for pain on the 7th day after surgery [(1.8±0.8) points] and incidence of complications [2.0% (1/51)] in the former were significantly lower than those in the latter [(3.0±0.6) points, 12.3% (8/65)] ( P<0.05). However, the surgical time [(70.4±6.9) min] in the former was significantly longer than that in the latter [(67.2±8.0) min] ( P<0.05). There was no statistically significant difference between the 2 groups in terms of incision healing, fracture healing time, VAS for pain on the first postoperative day, wrist range of movement at the last follow-up, grip strength, PRWE score, Gartland-Werley functional recovery, fracture alignment, palm angle, ulnar deviation angle, and radial height at the last follow-up ( P>0.05). Conclusions:Both the palmar minimally invasive approach by a single incision and the traditional palmar approach are effective for implantation of a locking plate in the treatment of distal radius fractures. However, the minimally invasive palmar approach is superior to the traditional palmar approach in terms of incision aesthetics, intraoperative bleeding, surgical trauma response, surgical time and surgical risk.
