Clinical Observation Of The Effect Of Type Ⅱ Ulnar Styloid Process Fracture On The Function Of Wrist After Distal Radius Fracture Operation

Object:To investigate the surgical treatment of distal radius fracture complicated with Hauck typeⅡulnar styloid process fracture and the effect of different surgical methods on the function of wrist joint after operation.Methods:Forty patients with distal radius fracture with Hauck typeⅡulnar styloid process fracture treated in the Department of traumatic Orthopedics of the second affiliated Hospital of Dalian Medical University from January 2017 to January 2020 were chosen as the research object of this paper.The 40 patients were treated with different treatment methods,the experimental group and the control group each had 20 cases.Both groups of patients underwent open reduction and internal fixation for distal radius fractures.Experimental group received surgical treatment of ulnar styloid process fracture,including hollow compression screw and breakable nail.Control group received external fixation treatment of ulnar styloid process fracture.The general data,the peri-operative data and the postoperative follow-up review data were collected between the two groups.The metacarpal inclination angle and ulnar deviation angle of the injured wrist were measured at the 12th month after operation to evaluate the fracture healing condition.The postoperative complications were recorded.Postoperative complications such as ulnar wrist pain,radioulnar instability and wrist range of motion were recorded,which was used as the basis for the determination of postoperative wrist function score and range of motion to evaluate the recovery of wrist function.The two group clinical data were compared due to assess the recovery of surgical treatment of Hauck typeⅡulnar styloid process fracture and the effect of different surgical methods on the function of wrist joint after operation.Results:1.Statistical results of general clinical data:the general patient data of the two groups were basically the same in terms of age,injury site and fracture to operation time,it shows that it is comparable in fracture healing and functional recovery,among the two groups of patients.2.Comparison of perioperative data:the two groups were compared,the amount of intraoperative blood loss was basically the same,and the difference was negligible(P=0.865>0.05).Surgical treatment takes longer because the fracture site is more extensive,and the length is longer because of the more incisions,and the differences were significant which P<0.05.3.Comparison of postoperative complications between the two groups:One patient had acute infection of incision after operation,one patient had ulnar pain of wrist joint,and 10%of patients had occurred postoperative complications.In the control group,none of the patients developed acute infection in the ulnar incision,but 45%of the patients did develop postoperative complications.Patients in the control group who received conservative treatment were more likely to have complications after surgery(χ~2=6.144,p=0.031,P<0.05).4.Comparison of postoperative imaging parameters:Imaging parameters of the experimental group and the control group were measured and compared at the 12th month after operation.Statistical analysis showed that surgical treatment had a significant advantage in patients with fracture healing condition.Based on the difference between healing and conservative treatment,the imaging data of patients with two different surgical methods in the experimental group were further compared.There was no significant difference in the fracture healing of distal radius and ulnar styloid process between the hollow compression screw group and the breakable nail group(P>0.05).5.Comparison of related indexes of wrist function:The Gartland-Werley wrist score and DASH score of the experimental group were much higher than those of the control group,and the recovery of wrist function was also better than that of the control group12months after surgery(P<0.05).Further statistical analysis showed that there was no difference in postoperative functional indexes between patients treated with two different surgical methods.Conclusions:1.Compared with conservative treatment,surgical treatment of distal radius fracture combined with HauckⅡulnar styloid fracture can reduce the incidence of complications,promote fracture healing,and better restore wrist joint function.2.There was no significant difference in the clinical effects of the two fixation methods of hollow compression screw and breakable nail.3.This research has a short period of time and a limited number of samples.Large samples and long-term clinical observations are needed for further research.