| Objective:Through the comparison of manipulative reduction and splint external fixation and plaster external fixation and external fixator fixation three methods of external fixation treatment efficacy of elderly patients with distal radius fracture analysis of external fixation for the treatment of mode choice of study of elderly patients with distal radius fractures.Methods:Retrospective analysis method was used in this study. Included in the study of 60 cases in accordance with the principles of randomized single blind from 2014 during March to October 2015 Shandong University of traditional Chinese Medicine Affiliated Hospital of orthopedics emergency cases and orthopedic ward were elderly closed distal radius fracture with external fixation in the treatment of patients, according to the treatment method will the divided into three groups: manipulative reduction and splint external fixation group(20 cases), manipulative reduction and plaster external fixation group(20 cases) with manipulative reduction and external fixation of external fixation group(20 cases). Before the injury patients were collected through the outpatient or follow-up after manipulative reduction, two days after operation, 1 week after operation, 4 weeks after operation, postoperative 8 weeks respectively uptake of limb wrist is lateral radiographs, measure and record the three groups of patients with radial height, ulnar deviation, palmar tilt, check and record the wrist function to recovery and so on. From three groups of patients with fracture reduction situation(analysis of neuroimaging data), fracture healing time and Gartland werley wrist joint function evaluation, complication and so on, on three groups of patients with clinical healing were compared and analyzed.Results:All the cases achieved bony union. Before treatment, there were no significant differences in gender, age, location of injury(left and right) and fracture classification. Three groups of patients with postoperative 8 weeks of fracture reduction situation(height of the radial, ulnar deviation palmar tilt) were: [(10.53±1.43)mm,(19.21±2.32)°,(9.36±1.76)°];[(10.47±1.25)mm,(19.23±1.64)°,(9.32±1.54)°];[(12.30±1.38)mm,(22.65±1.56)°,(11.20±0.98)°],Plaster splint group and the group between the two groups of data comparison, there is no significant difference, P > 0.05, the difference was not statistically significant, the splint and plaster group two groups and external fixator group data p < 0.05), the difference was statistically significant; three groups of patients at the time of the last follow-up anatomical score(excellent, good, poor,):[(5、11、3、1),(5、10、3、2),(12、6、2、0)],The excellent rates of splint group, plaster group and external fixation group were 80%, 75% and 90%, respectively.And plaster group data comparison, P > 0.05, the difference was not statistically significant, three groups compared P < 0.05, with statistical difference, show splint and plaster group, two groups of patients in anatomical restoration effect of the above almost, external fixator group of anatomical recovery effect is superior to that of the clamp plate group and plaster group. Fracture healing time were: [( 6.01±1.04)weeks,( 6.12±1.12)weeks,(7.15±0.98)weeks], plaster splint group and the group between the two groups of data comparison, there is no significant difference, P > 0.05, the difference was not statistically significant, three group P < 0.05), the difference was statistically significant, indicating that the plaster splint group, group two groups clinical fracture healing time to short in the external fixation group. Gartland werley wrist function score, splint were excellent in 6 cases, good in 10 cases, 4 cases, poor in 0 cases, the excellent and good rate was 80.00%; gypsum group and 5 cases, good in 9 cases, 5 cases, poor in 1 cases, the excellent and good rate was 70.00%; external fixator was excellent in 12 cases, 7 cases were good, 1 cases, the excellent and good rate was 95.00%, in terms of wrist function score: fixator group > splint group > gypsum group. During the treatment, the splint group 2 cases appeared tension blisters, timely release tie, application decongestant medications and was cured, gypsum group of wrist joint stiffness occurred in 1 case, in the late active functional exercises and joint activities basically returned to normal; external fixator group appeared in 1 cases of pin tract infection, by strengthening local wound dressing, antibiotic intervention treatment after symptoms were relieved.Conclusion:Three kinds of external fixation for treatment of elderly patients with distal radius fractures have clinical therapeutic effect, splint external fixation and plaster external fixation operation is simple and convenient, fracture patients recovery time is shorter. Patients can be achieve satisfactory recovery effect, the wrist function recovery effect, splint external fixation is better than plaster external fixation, but in terms of normal wrist joint function after the recovery of wrist physiological anatomical structure and operation, both of them have to is far inferior to that of the external fixators. |
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