The Clinical Research Of External Fixation With Small Splinting And Internal Fixation With T-plate In Treating Colles’ Fractures In Elderly Patients

Objective: To observe the clinical curative effect of external fixation with smallsplinting by manipulative reduction and internal fixation with T-plate by open reduction intreating Colles’ fractures in elderly patients. Methods: The research contains60elderlypatients of Colles fractures which are collected in orthopaedic clinic, orthopaedicemergency and orthopaedic ward of Shandong University of TCM Affilliated Hospitalfrom June2010to June2011.Each group contains30cases. In small splinting group, therewere9males and21females with an average age of70.23years (60-75years). Accordingto the AO classification system for fracture, there were7cases of type A2,6cases of typeA3,6cases of type C1,7cases of type C2, and4cases of type C3. The time from injury toadmission was between35minutes and2days with a mean time of1day. In T-plate group,there were7males and23females with an average age of69.37years (62-78years).According to the AO classification system for fracture, there were4cases of type A2,5cases of type A3,5cases of type C1,9cases of type C2, and7cases of type C3. The timefrom injury to admission was between30minutes and5days with a mean time of1.5day.To analyze the clinical curative effect of the two groups retrospectively according toX-ray evaluation, wrist function of the last follow-up and Gartland-Werley wrist functionscore. Results: All incisions obtained healing by first intention after operation in T-plategroup. All patients were followed up for9-12months (11.6months on average). Fracturehealing was all achieved according to X-ray inspection. There were no significantdifferences (P>0.05) in fracture healing time between small splinting group [(11.77±1.406) weeks] and T-plate [(12.13±1.676) weeks]. At last follow-up, the palmar tilt anglewas (6.44±0.63)°and (9.89±1.31)°, the radial inclination angle was (18.45±3.15)°and (20.16±1.61)°, and the radial length was (8.22±0.58) mm and (10.74±0.94) mm insmall splinting group and T-plate group, respectively showing significant differences (P <0.05) between two groups. There were no significant differences (P>0.05) in flexion andextension activity of wrist, radioulnar partial activity, pronation-supination activity, gripand pinch strength between two groups. According to the Gartland-Werley score, theresults were excellent in7cases, good in18cases, fair in3cases, and poor in2cases insmall splinting group, the excellent and good rate was83.3%; in T-plate group, the resultswere excellent in8cases, good in20cases, fair in1cases, and poor in1case, the excellentand good rate was93.3%, showing no significant difference (P>0.05) between two groups.Conclusions: External fixation with small splinting by manipulative reduction was inferiorto internal fixation with T-plate by open reduction in anatomic reduction for treating Collesfractures in elderly patients, but it still can achieve satisfactory functional outcomes.