Observation On The Efficacy Of Manual Reduction And Combined External Fixator In The Treatment Of Colles Fracture

Objective:To explore the effect of manual reduction on the recovery of anatomical structure of colles fracture and to compare and analyze the difference between combined external fixator and single-arm external fixator in the treatment of colles fracture,so as to provide some objective basis for clinical application of combined external fixator.Method:The 60 patients admitted from October 2018 to October 2019 who met the study criteria were randomly divided into 2 groups.30 cases of colles fracture were treated with manual reduction combined external fixator,including 8 males,22 females,22 left colles fractures and 8 right colles fractures,aged from 52 to 73 years,with an average age of 61.90 years.manual reduction and single arm external fixator were used to treat 30 cases of colles fractures,including 10 males,20 females,18 colles fractures on the left and 12 colles fractures on the right,aged from 51 to 74 years,with an average age of 61.20 years.Analysis and statistics of the operation time of each exception fixator fixation.The X-ray of the wrist joint of the affected side was examined before surgery,immediately after surgery,2 weeks,6 weeks and 12 weeks,and the indexes of metacarpal inclination,ulnar deviation and radius shortening were compared,and the results were recorded in detail.The anatomical score and wrist function score of each patient were recorded during the 12 th week of follow-up.The above data were analyzed by SPSS20.0 statistical software.Result:1.General situation:before treatment,there was no significant difference in sex,side and age between the two groups(P>0.05).2.Comparison of operation time: The fixed time of the combined external fixator was less than that of the single arm external fixator,and the difference was statistically significant(P<0.05).3.Comparison of metacarpal inclination,ulnar deviation and radius shortening: manual reduction was effective in the recovery of metacarpal inclination,ulnar deviation and radius shortening in the two groups of patients with colles fracture,and there was significant difference in the data before and after manual reduction(P<0.05).After manual reduction,whether using combined external fixator or single-arm external fixator,the metacarpal inclination angle and ulnar deviation angle can be well maintained,but the length of radius was lost in varying degrees.4.Comparison of the loss of radius shortening:the loss of radius shortening of combined external fixator after manual reduction(The difference between the radius shortening 6 weeks after surgery and the radius shortening immediately after surgery.)was less than that of single-arm external fixator.The difference was statistically significant(P<0.05).5.Comparison of anatomical score: The excellent and good rate of anatomical score in the follow-up of 12 weeks after operation for colles fracture treated with combined external fixator was higher than that for colles fracture treated with single arm external fixator by manual fixation,and the difference was statistically significant(P<0.05).6.Comparison of wrist function score: At the follow-up of 12 weeks after operation,wrist function score of combined external fixator fixation for colles fracture was better than that for single arm external fixator fixation,with statistically significant difference(P<0.05).7.Other complications:Combined type external fixator fixed nail infection occurred in 2 cases(6.67%,2/30),single arm external fixator fixed nail infection occurred in 1(3.33%,1/30),two groups of nail way infection is no statistical difference(P>0.05),two groups of nail infection of patients after the treatment and application of antibiotic treatment were cured,no two groups of patients took place,osteomyelitis and fixed screw loose.Conclusion:Manual reduction is effective in restoring the anatomical structure of colles fracture.Compared with the single-arm external fixator,the combined external fixator is better in the operation time and maintaining the radius length of colles fracture,and the excellent and good rate of anatomical score and wrist function score are higher,which is worthy of clinical recommendation.