A Clinical Study On The Effect Of Prescription Of ShangZhiSunShangXunXi In Treatment Of Primary Dysfunction Of Intra-articular Colles's Fracture

Objectives: To observe the clinical effects of Prescription of Shangzhisunshangxunxi intreatment of primary dysfunction of intra-articular Colles's fracture, and find out the relationbetween primary effect and malformation of distal radius, in order to guide the reasonableapplication of the prescription.Methods: 87 elder patients chosen according to the adoption standards competable withthe diagnoses of intra-articular Colles's fracture were randomly divided into twogroups(treatment group 48 cases and control group 39 cases). all patients were reducedmanipulatively and immobilized by plaster casts at slightly palmar flexion and ulnar deviationfor 4～6 weeks, and then begin a rehabilitative treatment for 8 weeks. Patients in thetreatment group were treated with Prescription of Shangzhisunshangxunxi. and functionalexercise, however patients in the control group only with functional exercise. We assess theanatomical result of distal radius after clinical union of fracture according to the scoringsystem based on the modification by Sarmiento et al(1980), and function scores of affectedwrist at pretherapy,2nd week,4th week,8th week according to the points system of Gartland andWerley modified by Sarmiento(1975). The anatomical result was divided into 4 group:excellence, good, fair, poor. All of the data were treated statistically.Results: (1) There is highly significant difference among the function scores atpretherapy and 2nd,4th,8th week in treatment group(P＜0.01), and the same in controlgroup(P＜0.01); there is highly significant difference between the function scores in treatmentgroup and control group at 2nd,4th,8th week(P＜0.01). It shows that effects in treatment groupand control group is obvious, but the former is better than the latter. (2) In treatment group,there is highly significant difference between functional scores with excellence and good grade, or with good and fair grade, or fair and poor grade of anatomical structure at 2nd, 4th, 8thweek(P＜0.01), except those with fair and poor grade of anatomical structure at 8th weekwhich there is no significant difference between(P＞0.05). It shows that the effects intreatment group positively and significantly correlated with anatomical structure of distalradius. (3) In control group, the difference of function scores between excellent and goodanatomical structure, and between good and fair, and between fair and poor, is showed asfollow: P＜0.01,P＞0.05,P＞0.05 at 2nd week, and P＜0.01,P＜0.05,P＜0.01 at 4th week, andP＜0.05,P＜0.05,P＞0.05 at 8th week. It shows that the effects in control group positivelycorrelated with anatomical structure of distal radius, but the variability was weaker than thatin treatment group. (4) There is highly significant difference at 2nd,4th,8th week betweenfunction scores in treatment group and control group with excellent anatomical structure ofdistal radius (P＜0.01), and the same with good structure(P＜0.01), significant difference withfair structure(P＜0.05), no significant difference with poor structure(P＞0.05).Conclusions:1. The Prescription of Shangzhisunshangxunxi combined with functional exercise, is asafe and effective therapy to significantly improve the primary wrist function of intra-articularColles's fracture after clinical union.2. The effect of Prescription of Shangzhisunshangxunxi positively and significantlycorrelated with anatomical structure of distal radius.3. When loss of radial length≤6mm, dorsal angle≤10°, loss of radial angle≤10°,displacement of articular surface≤2mm, the Prescription of Shangzhisunshangxunxicombined with functional exercise, could gain a primary satisfactory wrist function ofintra-articular Colles's fracture which is surperior to that only use functional exercise.