Observe The Effect Of Intra-articular Distal Radial Fractures After Conservative Treatment Or Surgical Treatment

Objective:Observation of conservative treatment and surgical treatment of intra-articular distal radial fracture displacement of the treatment effect.By comparing two different treatment methods.Study on conservative treatment and open reduction and internal fixation in distal radial intra-articular fractures of the advantages and disadvantages and the treatment of indications,provide a basis for the formulation in clinical treatment.Method:There were 66 patients in Zhongshan hospital of the TCM into line with the standard intra-articular distal radial fractures(CoonyⅣ) from January 2007 to January 2008 were observed.Age from 15-87years.Record the accepted treatment and the fracture healing time,and measure patients with X-ray after treatment.According to patients were given different treatments,patients were divided into conservative and surgical group.And conservative group,44 cases of patients,surgery group,22 cases of patients.Record patients with X-ray after fracture healing,and evaluate the wrist function in December 2008 to February 2009.After evaluation,analyze the recorded data by SPSS 16.0.Results:The contrast of the treated X-ray between two groups was not significant。No patients with nonunion was occur。There is no statistical significance in the healing time between two groups,(P>0.05).After fracture healing the reduction quality is measured and scored by X-ray,the surgical group average:0.136,and the conservative group average:0.796,statistical tests shows that the difference is significant(P<0.05).Compared with the surgery group,the conservative group lost reduction seriously after treat,but the appearance of complication between two groups was not significant. According to the rectified Green and 0'Brien wrist criterion,2 cases were rated as excellent and 9 as good and 18 as fair and 15 as poor in the conservative group.And 3 cases were rated as excellent and 9 as good and 8 as fair and 2 as poor in the surgical group.The difference between two group is significant (P<0.01),the wrist function of the surgical group significantly better than the conservative group.Conclusion:For intra-articular distal radial fractures,whether use manipulative reduction and external fixation or open reduction and internal fixation,it has little effect on the fracture healing time and the appearance of complications after treatment.And closed reduction can restore the three-dimensional anatomical structure of distal radius,but the reduction easily loss.It is necessary for a external fixation patient to review the X-ray actively,and adjust the splint timely to minimize the loss of reduction.Open reduction and internal fixation surgery was better than closed reduction,external fixation.However,which method to choose in clinical should be based on the patient's specific circumstances.