Analysis Of The Factors That Influence The Curative Effect For Comminuted Distal Radius Fracture

Objects: To evaluate the wrist function and image materials of the patients with comminuted distal radius fracture after manipulative reduction and splint external fixation, analyze the factors which influence the wrist function, then clinical treatment can be guided.Methods: 62 patients who suffered comminuted distal radius fracture and accepted manipulative reduction and splint external fixation were chose. According to AO classification ,there are 18 A3,25 C2,19 C3 fractures. The treatment was did by the same doctors. All the patients were followed up 1W, 2W ,4W ,3M after the initial visit in the ER of our hospital and standard AP and lateral X-ray examination was taken every time. Three month later PRWE wrist function grading system was used to evaluate wrist function. The results were divided into excellent, good, ok and bad . The palmartilt, radial inclination and radial shortening in the first two and last films were measured accurately. Lidstrom grading system was used to grade the image results 3 M later. Then analyze the factors which influence wrist function.Result: According to PRWE wrist function grading system, 80.1% patients achieved well wrist function while only 44.4% young patients with C3 type fracture achieved that. Old patients achieved better wrist function than young patients (P＜0.05). The fracture without joint fracture achieved better results than others (P＜0.05). All old patients which belong to LidstromⅠor LidstromⅡand young patients which belong to LidstromⅠachieved well wrist function while 57.1% young patients which belong to LidstromⅡgot well wrist function. Only 22.2% patients which belong to LidstromⅢorⅣgot well wrist function. Young patients got better image results than the old when the fracture healed (P＜0.05).Conclusion:1 For comminuted distal radius fractures, age,fracture type and image results are important factors which influence the wrist function. 2 Old patients can make manipulative reduction and splint external fixation as the first choice. But young patients with C3 type fracture did not achieve good clinical results with this method. 3 The standard of reduction for young patients should not be worse than LidstromⅠ, while it should be better than LidstromⅡfor old patients.