Clinical Study Of Manipulative Reduction Combined With Modified Kirschner Wire Internal Fixation For The Treatment Of The Elderly Unstable Distal Radius Fractures

ObjectiveThrough the comparative study of clinical curative effect of manipulative reduction combined with modified kirschner wire internal fixation and open reduction and plate screw internal fixation for the treatment of the elderly unstable distal radius fractures,to provide the clinical basis for the treatment of unstable distal radius fractures in elderly patients.MethodsFrom March 2015 to September 2016,a total of 60 cases of elderly patients with unstable distal radius fracture were randomly divided into 2 groups,each group of 30 cases,the study group received manipulative reduction combined with modified kirschner wire internal fixation,and the control group was treated with open reduction and plate screw internal fixation.Recorded the operation time and blood loss in 2 groups;Before-operation,after-operation,postoperative-6 week,postoperative-3 month,two groups of patients were taken X-ray,and then measured the palmar tilt,ulnar deviation and radius height in X-ray;Postoperative-day,postoperative-3 day,postoperative-1 week,postoperative-6 week,used the visual analogue pain score(VAS)to evaluate the wrist pain in the two groups;postoperative-3 month and postoperative-6 month,used Gartland-Werley wrist score to evaluate wrist joint function in 2 groups;Recorded the incidence of postoperative complications,length of stay,treatment costs and patient satisfaction of the two groups;Statistical software SPSS 22 was used to analyze the statistical data.ResultComparison of two groups of patients with basic data,the difference was not statistically significant(P>0.05);The operation time and blood loss in the experimental group significantly less than those in the control group,the differences were statistically significant(P<0.05);VAS comparison of postoperative-day?postoperative-3 day?postoperative-1 week,the differences were statistically significant(P<0.05),VAS comparison of postoperative-6 week,the difference was not statistically significant(P>0.05);Comparison of palm inclination of before-operation?after-operation?postoperative-6 week?postoperative-3 month,the differences were not statistically significant(P>0.05),comparison of radial height of before-operation?after-operation,the differences were not statistically significant(P>0.05),comparison of radial height of postoperative-6 week?postoperative-3 month,the differences were statistically significant(P<0.05),comparison of ulnar deviation of before-operation,the difference was not statistically significant(P>0.05),comparison of ulnar deviation of after-operation?postoperative-6 week?postoperative-3 month,the differences were statistically significant(P<0.05);postoperative-3 month,used Gartland-Werley wrist score to evaluate wrist joint function in 2 groups,the postoperative-3 month,the excellent and good rate of the study group and the control group were 66.67%?76.67%,the differences was not statistically significant(P>0.05),and the postoperative-6 month,the excellent and good rate of the study group and the control group were 83.33%?86.67%,the difference was not statistically significant(P>0.05);length of stay,treatment costs in the study group were significantly less than those in the control group,the differences were statistically significant(P<0.05);the incidence of postoperative complications in the study group and the control group were 3.33%?10.00%,the difference was not statistically significant(P>0.05);the satisfaction rate of the study group and the control group were 93.33%?73.33%,the difference was not statistically significant(P>0.05).ConclusionTwo kinds of treatment for elderly patients with distal radius fractures have good clinical efficacy,manipulative reduction combined with modified kirschner wire internal fixation less then open reduction and plate screw internal fixation in the recovery of the palmar tilt?ulnar deviation and radius height,however,there was no difference in the recovery of wrist function,and the former hospitalization days,treatment costs were significantly lower than the latter,the former satisfaction higher than the latter.Considering the special physiological stage of the elderly,manipulative reduction combined with modified kirschner wire internal fixation for the treatment of unstable distal radius fractures is more easily accepted by elderly patients.