Therapeutic Effects Of Different Fixation Methods Of Fragment Of The Dorsal Ulnar Of Distal Radius Fracture

Objective: This study retrospectively analyzed the imaging data and wrist function score of palmar approach plate combined with dorsal approach plate and palmar approach plate combined with dorsal closed reduction fixation in the treatment of distal ulnar dorsal radius fracture.To explore the related factors affecting the clinical treatment of ulnar dorsal fracture of distal radius fracture and to provide a clearer diagnosis and treatment basis for the treatment of distal ulnar dorsal radius fracture.Methods: According to the inclusion and exclusion criteria,53 patients with closed distal radius fracture(with ulnar dorsal fracture block)were selected from August2018 to June 2019 in the Department of Orthopaedics of the The author’s hospital Of these,23 were men,Thirty women,AO type: B1 type 3 cases,B2 3 cases,B3 5 cases,C1 8 cases,C2 7 cases,C3 type 5 cases.A group(n=22): the metacarpal Herry incision of the affected wrist joint was taken,the metacarpal fracture block of the distal radius was exposed and directly reduced,and the appropriate length of the metacarpal anatomical locking plate of the distal radius was in the metacarpal fixation of the distal radius,and the distal carpal dorsal carpal(Lister tubercle ulnar)of the forearm was exposed to the distal ulnar dorsal fracture block incision along the distal carpal dorsal carpal(radial)of the forearm.If the fixation is unstable,Kirschner needle or 1/2 block was supplemented with reduction 5 mm Miniature metacarpal or phalangeal plate with longitudinal screw fixation and plaster fixation of the affected wrist for 2 weeks.B group(n=31): the patient took the metacarpal Herry incision of the affected wrist joint,first exposed the distal metacarpal fracture block of the radius,directly reduced the metacarpal fracture block,selected the appropriate length of the distal metacarpal anatomical locking plate to be placed in the distal metacarpal fixation of the radius,and then achieved the reduction of the dorsal ulnar fracture block by traction,extrusion and rotation of the wrist joint.After operation,the affected wrist joint was fixed with plaster support for 2 weeks.After regular follow-up,wrist X radiographs were taken to observe the changes of distal palmar inclination angle,ulnar deviation angle,radius height and displacement of dorsal ulnar fracture,Gartland-Werley wrist function score system was used to evaluate the recovery of wrist function,and the irritation and injury of extensor tendon around wrist joint were observed.Results: 1 A total of 53 patients received 10-14 months follow-up,no incision infection and obvious vascular and nerve injury,2 two days and the last follow-up,there was no significant difference between the two groups palm inclination,ulnar deviation,radius height(P >0.05);3 Gartland-Werley wrist function score showed that the excellent and good rate of wrist function Gartland-Werley score in A group was 90.9% higher than that in B group 83.9%,there was no significant difference(P>0.05);4 Postoperative complications,The incidence of late displacement of distal ulnar dorsal fracture block of radius was higher than that of A group B 16.1%,difference was statistically significant(P<0.05),A group 13.6%,6.5% in B group,and the difference was not statistically significant(P>0.05).Conclusion: The treatment of ulnar dorsal fracture block with palmar approach plate combined with dorsal approach plate and palmar approach plate combined with dorsal closed reduction treatment of ulnar dorsal fracture block of distal radius fracture.However,palmar approach plate combined with dorsal approach fixation can more effectively prevent the transposition of ulnar dorsal fracture block.