A Research To Evaluate Clinical Efficacy Of The Type C Distal Radius Fracture In The Elderly Treated By Wu Men Manipulation And Combined With Double Splint

Objective:To observe and evaluate the clinical effect of Wumen manual reduction and splint fixation in the treatment of C-type distal radius fracture in the elderly,and to contrastively analyze the difference of curative effect between Wumen four-step reduction method and open reduction plate internal fixation for distal radius fracture.Methods:1.Retrospective analysis:The clinical efficacy of ABC type III(based on AO classification)fracture treated by four-step reduction method of Wumen bone injury and external fixation of septic paper splint for unilateral distal radius fracture in our hospital in recent 3 years(April 2016-April 2019)was retrospective analyzed.2.Prospective study:A total of 70 elderly patients with C distal radius fracture treated in Suzhou Hospital of Traditional Chinese Medicine from October 2018 to December 2019 were collected and divided into treatment group and control group according to their treatment willingness.Treatment group in the wu door technique combined splint external fixation treatment,control group to take volar open reduction and internal fixation treatment,separately from the main curative effect standard(clinical curative effect,Green-O ’Brien score)and secondary index(palm Angle,foot Angle,radial height,fracture healing time,length of hospital stay,health economics evaluation,complications,etc)to analyze the clinical curative effect of patients with evaluation and research.Results:1.Baseline data of the three groups(gender,age,cause of injury,time to visit the doctor)were compared,P values>0.05,the difference was not significant and was comparable.The Green-O’Brien score of patients with type A and B were significantly better than those with type C(P values<0.05).There were no statistical differences in clinical efficacy,last imaging evaluation index and fracture healing time among the three groups(P values>0.05).2.Baseline data(gender,age,cause of injury,time to visit the doctor)of the manipulation group and the surgery group were compared,P values>0.05,the difference was not significant and was comparable.Clinical efficacy:the difference between the manipulation group and the operation group was not significant,P values>0.05,which proved that the efficacy of the manipulation group and the operation group was similar.Green-O’Brien score:Compared with the operation group before treatment,P values>0.05 was comparable between the manipulation group and the operation group.After treatment,P values<0.05,the operation group was significantly better than the manipulation group.Imaging observation indexes:Before treatment,the two groups were compared(P values>0.05),which was comparable.The palmar inclination Angle and ulnar deviation Angle on the day after treatment were compared between the two groups(P values>0.05),the difference was not significant,while the radius height was compared between the two groups(P values<0.05),which proved that the radius height in the manual group was significantly higher than that in the operation group after reduction.Comparison of palmar inclination Angle and ulnar deviation Angle at 1 week,3 months and 12 months after treatment showed P values<0.05,while comparison of radius height at 1 week,3 months and 12 months after treatment showed P values>0.05,which proved that the operation group could better maintain the palmar inclination Angle,ulnar deviation Angle and radius height after reduction.Fracture healing,length of hospital stay,health economic evaluation:Comparison of fracture healing time between the two groups,P values>0.05,no statistical difference;Compared with the evaluation of health economics,P values<0.05,the manipulation group was significantly better than the operation group;The length of stay in the manipulation group was significantly shorter than that in the operation group,P values<0.05.Complications:P values>0.05 in the manipulation group and the operation group,there was no significant difference between the two groups.Conclusions:1.Wu men technique with double splint therapy three type A,B,C are good short-term therapeutic effects of distal radius fracture.2.compared with the surgical treatment of type C fracture of the distal radius,although the anatomy of the registration and maintain anatomical position of reduction is poorer,but Wu men technique combined double door splint treatment shorter hospitalization time,better health economics evaluation.