| Objective: To investigate the curative effect of volar approach locking plate internal fixation combined with vascular clamp poking reduction technique in the treatment of distal radius fracture combined with ulnar dorsal displaced fragment.Methods: A retrospective analysis was made on 78 patients with distal radius fractures(DRFs)who were treated with volar locking plate internal fixation in our hospital from January 2015 to December 2018,and were divided into conventional reduction group(CRG)and poking reduction group(PRG)according to whether the ulnar dorsal bone fragment was poking reduction by vascular forceps during the operation.33 cases in CRG group(14 males and19 females)and 45 cases in PRG group(11 males and 34 females).The operation time,intraoperative blood loss,primary bone graft and intraoperative blood transfusion were recorded.Follow-up at 3 months,6 months and 12 months after operation,DASH score was used to evaluate the functional recovery.During the 12-month follow-up,Mayo score was used to evaluate wrist joint function,visual analog scale(VAS)was used to evaluate the pain of patients during rest and movement of wrist,and anteroposterior radiographs were used to measure imaging parameters(volar tilt,radial inclination and radial height)of the affected wrist.Results: There was no significant difference in baseline data between the two groups(P > 0.05).There was no significant difference in the average operation time and intraoperative blood loss between the two groups(P > 0.05).All patients were followed up.At 3 months after operation,there was no significant difference in DASH score between the two groups(P > 0.05).At 6 months and12 months after operation,the DASH score of PRG group were better than that of CRG group(P < 0.05).There was no significant difference in Mayo score between the two groups 12 months after operation(P > 0.05).There was no significant difference in VAS scores between the two groups at rest at all follow-up time points(P > 0.05).In wrist joint activity,there was no statistical difference in VAS scores between the two groups at 3 months after operation(P > 0.05).VAS scores in CRG group were higher than those in PRG group at6 months and 12 months after operation(P < 0.05).There was no significant difference in wrist joint range of motion(palmar flexion,dorsal extension,ulnar deviation,radial deviation)and imaging parameters(volar tilt,radial inclination,ulnar deviation,radial height)between the two groups(P > 0.05).Conclusion: Volar locking internal fixation combined with vascular clamp“poking reduction” technique can effectively reduce and fix distal radius fracture of ulnar dorsal displaced fragment.Compared with patients with distal radius fracture without special reduction of ulnar dorsal fragment,this technique enables patients to have better long-term functional recovery. |
