The Clinical Research Of Kirschner Wire Internal Fixation Combined With Plasterslab External Fixation Treating Middle And Old-aged Distal Radius Fracture

ObjectiveThrough clinical observation of the treatment and follow-up in the Kirschner wire internal fixation combined with plaster slab external fixation treating middle-aged and old distal radius fracture, analyze and discuss its clinical curative effect.MethodCollect 60 cases of middle-aged and old distal radius fracture which are from huangshi traditional Chinese medicine hospital. They were outpatient and the inpatient in orthopaedics department ? in March 2013?October 2015. Divided them into treatment group and control group,30 cases in each group. The treatment group were treated with Kirschner wire internal fixation combined with plaster slab external fixation, and the control group were treated with closed reduction and small splint external fixation. Depending on the degree of osteoporosis in patients, gave treatment accordingly. All of them were given the internal and external treatment of TCM made by the hospital. During the treatment, patients did the appropriate functional exercise under the doctors' guidance.Taking X-ray radiographs and lateral radiographs, then measured radial inclination, ulnar inclination and the length of the radial shortening before treatment,4 weeks,3 months,6 months after treatment respectively. Observed and compared the average healing time of two groups, fracture malunion, needle eye infections, the rate of good efficacy in fracture healing, the rate of good function of wrist joint. All data collected by using SPSS21.0 and choose corresponding software.ResultAll patients included in the study were followed up. After 4 weeks to 6 months follow-up, all subjects had clinical healing. At 4 weeks,3 months and 6 months review they were taken X-ray radiographs and lateral radiographs. Evaluated the fracture healing according to the practical fracture healing evaluation criteria, and evaluated the wrist joint function according to the Dienst evaluation criteria. The internal fixation combined with plaster external fixation group had 0 cases of fracture malunion, 1 case of needle eye infection, no needle loose or fall off, without tendon and nerve damage, and so on;Small splint external fixation group had 4 cases of fracture malunion, no needle eye infection, no needle loose or fall off, no tendon and nerve damage, and so forth.Collected data analysis is as follows:1. By chi-square analysis, the treatment group and control group in gender, age, fracture damage mechanism and fracture type, P >0.05, no significant difference, comparable.Before the treatment, two groups of patients in radial inclination, ulnar inclination and the length of the radial shortening, P> 0.05, no significant difference, comparable.2. By the rank sum test analysis, the average healing time of Colles fracture, Smith fracture, Barton fracture in the treatment group and control group, P> 0.05, no significant difference.3. The internal fixation combined with plaster external fixation group had 1 case of needle eye infections, recovered after symptomatic treatment in time. The control group adopts small splint external fixation treatment, there is no possibility of infections, so there is no sense of comparation.4. By chi-square analysis, the rate of fracture malunion of the two groups, P< 0.05, there is significant difference, the rate of fracture malunion in small splint external fixation group was higher than the internal fixation group, the results have statistical significance.5. By chi-square analysis, the rate of good efficacy in fracture healing of the treatment group and control group, P>0.05, the two group had no difference in the rate of good efficacy in fracture healing,the comparation has no statistical significance.6. The chi-square analysis, the rate of good function of wrist joint in the treatment group and control group, P> 0.05, there is no significant difference, the results have no statistical significance.7. By the rank sum test analysis, the radial inclination, ulnar inclination and the length of the radial shortening in two groups of patients after treatment compared with before, P< 0.05, there is significant differences, the two methods of treatment can correct the radial inclination, ulnar inclination and the length of the radial shortening, which has clinical significance. After treatment, the radial inclination, ulnar inclination and the length of the radial shortening compared between groups, P< 0.05, there is significant differences, internal fixation is better than the small splint external fixation in correcting the radial inclination, ulnar inclination and the length of the radial shortening, have clinical significance.ConclusionResearch statistics show that in the treatment of middle-aged and old distal radius fracture, the Kirschner wire internal fixation combined with plaster slab external fixation is a method of simple operation, little injury, pain relief, and the patients can do function recovered rehabilitation exercise early and satisfactorily. And it can bring about fewer complications. With low rate of fracture malunion, high rate of good efficacy in fracture healing, high rate of good function of wrist joint, and correcting tradial inclination, ulnar inclination and the length of the radial shortening effectively, Kirschner wire internal fixation combined with plaster slab external fixation therapy is a good choice when treating middle-aged and old distal radius fracture.