| ObjectiveThe purpose of this topic is based on the closed reduction and splint external fixation and volar plate and screw internal fixation (ORIF(Open Reduction with Internal Fixation)) classification of AO type C of the distal radius fracture clinical observation, before the reset, and the clinical healing of bone fracture after reset when one side of the wrist X-ray films respectively, measure each side wrist X-ray films of ulnar inclination Angle and palm and radial height and bone imaging parameters, analysis of the two kinds of before and after the treatment of fracture and shift of the situation, combined with the follow-up of wrist joint Cooney function score, analysis of the two kinds of wrist joint function recovery in patients with treatment.MethodsProspective studies between January 2014 and February 2014 orthopedics hospital affiliated to guangzhou Chinese medicine university of AO classification C in elderly patients with fracture of the distal radius:closed gimmick reset splint external fixation treatment as the observation group (hereinafter referred to as splint group), the volar plate and screw internal fixation (ORIF(Open Reduction with Internal Fixation)patients as control group (hereinafter referred to as steel plate group)).1, two groups according to AO classification standard to classify belongs to the patients of type C, instruct patients after reset back to the hospital visit on a regular basis. Record its reset before and after the reset, clinical healing of fracture of lateral wrist ulnar inclination Angle and palm and radial height and bone imaging parameters, compared before and after the fracture and the clinical healing of fracture.2, patients to 3 months after treatment, follow-up, through Cooney function score evaluation function of wrist joint, respectively from the pain, function, scope of activities, flexing and stretching, grip strength, rotation rate etc., used to evaluate the recovery of wrist joint function in patients with two groups.3, using SPSS20.0 statistical software for data processing, measurement data using t test, counting data using X2 test, the conclusion.ResultsSuccessful follow-up of patients with a total of 57 cases, of which the splint group 28 cases, steel group 29 cases.1, closed reduction and splint external fixation in the treatment of AO classification type C of the distal radius fracture with open reduction and volar plate fixation, fractures in patients with clinical healing time difference was statistically significant (P< 0.05), in this study, splint group clinical healing time of 33.57+/-3.929 days, steel group clinical healing time of 36.14+/-3.623 days, can be thought of manual reduction and splint external fixation treatment than ORIF(Open Reduction with Internal Fixation) volar plate fixation of AO classification type C of the distal radius fracture clinical healing time is shorter.2, the AO classification of the distal radius fracture type C overall comparison and contrast between the same subtype, closed gimmick reset splint external fixation treatment compared with open reduction and volar plate internal fixation, after reset, fracture clinical healing, compared before and after the reset, clinical healing of fracture and reset after lost ulnar inclination Angle and palm and radial height difference was statistically significant (P< 0.05), steel group is better than splint group as a whole. 3, closed reduction and splint external fixation in the treatment of AO classification type C of the distal radius fracture with open reduction and volar plate fixation, postoperative 3 months Cooney wrist score no statistically significant difference (P> 0.05), can be thought of manual reduction and splint external fixation treatment and open reduction volar plate fixation of AO classification C treatment of distal radius fracture can get satisfactory results.Conclusion1, for the classification of AO type C fractures of the distal radius fracture clinical healing, manual reduction and splint external fixation treatment than ORIF(Open Reduction with Internal Fixation) volar plate fixation fracture clinical healing time is shorter. This may with manual reduction and splint external fixation to avoid the "blow" secondary trauma and open reduction volar plate fixation for destruction of periosteum and blood supply.2, for ulnar inclination Angle and palm and radial height restore and maintain, volar plate internal fixation (ORIF(Open Reduction with Internal Fixation)) effect is better than that of closed reduction and splint external fixation.This may be because the closure technique reduction and splint external fixation is closed gimmick reset, rely on the experience of performer and "will touch the heart", and its fixed belongs to "elastic" fixed, use splint on distal radius around ligament and muscle force binding effect and fixed the fracture end, because of the elderly patients with osteoporosis, so late imaging lost more serious.Cut open reduction volar plate fixation is under the direct reduction, steel plate directly fixed on distal radius fracture end, fracture counterpoint is better to the line, fixed more secure.So open reduction volar plate fixation of distal radius fractures imaging better recovery, late imaging loss less.3, for the classification of AO type C wrist joint function recovery of the distal radius fracture, reduction and splint external fixation and open reduction volar plate fixation can get satisfactory results.Anyway, for the classification of AO type C of the distal radius fracture should be according to the specific condition of patients, to assess the pros and cons, the choice of treatment for master the indications and contraindications for the treatment of each, take the individualized treatment. |
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