Clinical Study On ORIF And CTEF For The Treatment Of Unstable Distal Radius Fractures

Objective: To evaluate the advantages and disadvantages with Open reduction and internal fixation(ORIF)or Closed reduction and external fixation(CREF) of unstable distal radial fractures.Methods: Selected the patients who was diagnosed of unstable distal radius fractures in the People’s Hospital of Gansu Province, since October 2013 to November 2015,according to the inclusion and exclusion criteria.All patients were divided into group ORIF and group CREF depending on those treatment. 28 males and 38 females patients were included in our research and the average age was 48.26 ± 13.37 years. 39 patients in group ORIF and 27 patients in group CREF. All patients were classified by AO classification,type A3 was 6 cases, and type B was 30, type C was 30. All patients have to retained the videography data of preoperative, postoperative, 3 months postoperative, 6 months postoperative. The total amount of blood loss, operation time, wound infection, the recovery of palmar tilt angle, radial inclination, ulnar variance, and the loss of those iterms, redisplacement of fracture fragment, fracture healing time, total cost of treatment, Gartland and Werley score of wrist function, patients subjective satisfaction. All indexes on the data were analyzed to evaluate the advantages and disadvantages of various treatment options.Result:The follow-up time of the group ORIF was 8.1 ± 4. 1 monthes, and group CREF was 7.2 ± 4. 5 monthes. Two groups of patients wounds were healing well; The recovery of anatomical structure were satisfactory, but the group ORIF was better than group CREF(P <0.05). The blood loss of ORIF was more than CREF,and the operation time was longer than CREF too(P <0.05). All fractures were healed without delayed union or nonunion, but the healing time of ORIF was longer than CREF(P <0.05). Complications occurred in both the two groups, group ORIF made a high incidence of osteoporosis, and the remaining two complications occurred no significant difference of group CREF(P> 0.05). The cost of ORIF group was more than the other(P <0. 05).Both patients with wrist function Gartland and Werley score excellent rate and subjective patient satisfaction were high, but there is no significant difference(P> 0.05).Conclusion:1. Both ORIF and CREF can receive satisfactory results in the treatment of unstable distal radius fractures.2. The blood loss of ORIF was more than CREF, and the surgery time is longer than the latter.3. The ORIF would get a beter reset than CREF, and the loss situation was better.4.The cost of ORIF was more than CREF.5. The wrist function was satisfied with those two treatments.6. Both the two treatments can get higher satisfaction.7. The two methods have advantages and disadvantages of distal radius fractures, doctors need to select an individualized treatment programs according to the patients conditions.