| Objective: The distal radius fractures is the fracture which is apart from the distal radius articular surface within 3 cm, it commonly present in the emergency department, annual incidence is >60,000. Because it is very common, many doctors have focused on it. The major clinical manifestations is that the activities limited wrist flexion and extension, swelling, pain and deformity. If distal radius fracture is treated incorrectly, it is easy to cause carpal tunnel in chronic pain and stiffness and affect the function of hand. How to treat this disease? In our opinion, as far as stable distal radial fracture, we often choice the non-surgical treatment such as the external fixation of plaster or small splint fixation which can achieve good results. As far as unstablefracture, due to the serious damage of distal articular surface, bone tissue is severe and the fractures are unstable. It is very hard to reset, therefore the choice of proper treatment is necessary. Power type external fixators are widely used in distal radius fracture due to theirs widely adaption, limted damage, simple operation, firmly fixation, to practise train waist function as soon as possible. Our research investigated the curative effect of plaster fixator, external fixator and power type external fixator on treating distal radius fracture, in order to discuss the best treatment for distal radius fracture.Methods: From August 2012 to October 2013, 143 cases of distal radius fracture treated in the third hospital affiliated He Bei medical university were collected. Among them, 98 cases met the requirements and had the whole data, male patients are 57 and female patients are 41, the average age is 50.75 years old. The follow-up time is six months, and we recorded the patients’ data on the three day, three month and six month after operation. All of the patients were divided into three groups dependent on their therapy method. A: plaster fixator group, 32 cases; B: tranditional external fixator, 33 cases and C: power type external fixator, 33 cases. We compared the three groups according to the palm inclination, ulnar deviation, Dinest scale of wrist joint function, the score of VAS.Results:1 Three groups were compared in palm inclination and ulnar deviation before and after operation, there was obvious statistical significance(P<0.01). The ulnar deviation of three groups before operation is 10.78±4.241, 8.84±5.321, 8.78±4.681, the data in six month after operation is 21.82 ±2.501, 22.72±2.231, 22.84±2.121. The palm inclination of three groups before operation is-13.67±11.124,-13.86±12.081,-13.98±12.074. The data in six month after operation is 11.74±1.432, 12.51±1.518, 13.01±1.622, suggesting the curative effect had obvious improvement on anatomical structure and clinical cure after the treatment of three groups.2 Three groups wre compared in two aspects of palm inclination and ulnar deviation in different time point, the data of palm inclination, in plaster fixat or group, the three day after operati,on is 11.39±1.581, the three month after operation is 11.50±1.596, the six month after operation is 11.74±1.432. In the tranditional external fixator group, the three day after operation is 12.04±1.732, the three month after operation is 12.36±1.495, the six month after operation is 12.51±1.518. In the power type external fixator group, the three day after operation is 12.80±1.584, the three month after operation is 12.94±1.533, the six month after operation is 13.01±1.622. The data of ulnar deviation, in plaster fixat or group, the three day after operati,on is 21.45±2.111, the three month after operation is 21.78±2.324, the six month after operation is 21.82±2.501. In the tranditional external fixator group, the three day after operation is 22.25±2.301, the three month after operation is 22.54±2.432, the six month after operation is 22.72±2.231. In the power type external fixator group, the three day after operation is 21.75±2.821, the three month after operation is 22.36±2.280, the six month after operation is 22.84±2.121. There was no significant difference among them(P> 0.05), shows that no differences were found among three groups in wo aspects of palm inclination and ulnar deviation.3 Three groups were compared in the VAS score in three month and six month after operation, no differences were found among three groups(P>0.05). In the three month after operation, in plaster fixat or group, the patients with painless were 23, the painless ratio of all the patients was 71.9%. Two patients had a fracture pain, six patients had the initiative pain, three patients had a wrist ulnar pain, six patients had mild pain and three patients had moderate pain. In the tranditional external fixator group, the patients with painless were 24, the painless ratio of all the patients was 72.7%. Two patients had a fracture pain, six patients had the initiative pain, three patients had a wrist ulnar pain, seven patients had mild pain and two patients had moderate pain. In the power type external fixator group, the patients with painless were 24, the painless ratio of all the patients was 72.7%. Three patients had a fracture pain, five patients had the initiative pain, three patients had a wrist ulnar pain, seven patients had mild pain and two patients had moderate pain.In the six month after operation, in plaster fixat or group, the patients with painless were 24, the painless ratio of all the patients was 75%. Two patients had a fracture pain, five patients had the initiative pain, three patients had a wrist ulnar pain, five patients had mild pain and three patients had moderate pain. In the tranditional external fixator group, the patients with painless were 25, the painless ratio of all the patients was 75.8%. Two patients had a fracture pain, five patients had the initiative pain, three patients had a wrist ulnar pain, six patients had mild pain and two patients had moderate pain. In the power type external fixator group, the patients with painless were 25, the painless ratio of all the patients was 75.8%. Three patients had a fracture pain, four patients had the initiative pain, three patients had a wrist ulnar pain, six patients had mild pain and two patients had moderate pain.4 Three groups were compared in Dinest scale of wrist joint function in three month and six month after operation, the differences were statistically between power type external fixator group and plaster fixator group, tranditional external fixator group(P<0.05), The data of three groups in three month is 62.5%, 63.6%, 78.8%, P1=0.029<0.05;P2=0.018<0.05. The data of three groups in three month is 68.8%, 69.7%, 87.9%. P1=0.0038<0.05;P2=0.0023<0.05, suggesting power type external fixator group was better than plaster fixator group and tranditional external fixator group in the early recovery of wrist joint function.Conclusions:1 Power type external fixator gained good effects in the recovery of distal radius anatomic structure and wrist jiont function.2 Power type external fixator had some merits, such as satisfactory reduction, firmly fixation, micro trauma, simply operation and good recovery, thus it is worth to promote in clinical treatment.3 Tranditional method also had a certain effect for older patients and slighter injury patients, therefore doctors should consider the choice of treatment syntheticly according to patinnts’ conditions. |
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