Comparative Study Of Clinical Efficacies Of Closed Reduction With External Plaster Fixation And Open Reduction With Internal Plate Fixation For Type A3 Distal Radius Fracture In The Elderly

Objective: The purpose of this study was to observe and compare the clinical effect of closed reduction and external plaster fixation and open reduction and internal plate fixation in the treatment of type A3 distal radius fracture in elderly patients,to explore the advantages and disadvantages of these two treatment options,in order to provide a theoretical basis for the clinical treatment of elderly patients with type A3 distal radius fracture.Methods: The clinical data of 80 patients with distal radius fracture treated in our hospital from January 2015 to January 2018 were collected.Forty-four patients who underwent closed reduction and external plaster fixation were defined as the nonoperative group and 36 patients who underwent open reduction and internal plate fixation as the operative group.Imaging data and clinical efficacy scores were collected at 6 weeks,3 months and 12 months after operation.The two groups of patients were compared and analyzed in terms of imaging indicators(radius height,palmar inclination and ulnar deviation)and clinical efficacy scores(the scores of Gartland and Werley and Patient-Rated Wrist Evaluation).Results: All the 80 patients were followed up for 12 to 24 months,with an average of 13.3 months.In terms of imaging indicators,the operative group was significantly superior to the non-operative group in radius height,palmar inclination and ulnar deviation(P < 0.05).In terms of clinical efficacy,the operative group was significantly superior to the non-operative group in G-W score and PRWE score at 6 weeks and 3 months after treatment(P < 0.05);however,there was no significant difference in G-W score or PRWE score between the two groups at 12 months after treatment(P > 0.05).Conclusions: For the elderly patients with type A3 distal radius fracture,open reduction and internal plate fixation can make the wrist joint recover well in the early stage,and can significantly correct the important anatomical parameters of the distal radius.Additionally,patients can obtain satisfactory clinical efficacy from both of the two treatment options after one year of rehabilitation training.