Observe The Effect Of Distal Radial Fractures Fixed In Two Different Position

ObjectiveThis topic research aimed to investigate the correlation between the curative effect and the fixed position of distal radial fractures which is closed reduction and splint external fixation, Come to the relatively best fixed position of distal radius fractures and analyze the biomechanical principles。MethodsFrom Jan.2011to Jan.2012,87cases of distal radial fractures were collected from the Third affiliated hospital of Guangzhou University of TCM. It consisted of20male and67female, The average age was51.6, range from18to60. Patient was given manipulative reduction and fixed in one kind of the position, Group A:Wrist fixed in palmar flexion and ulnar deviation and forearm pronation,40cases of patients; Group B:Wrist fixed in dorsal extension and ulnar deviation and forearm supination,47cases of patients; These cases were followed up2months after treatment. The effect of treatment was evaluated according to the radiology results and wrist function and complication, we stored the data and the score which accord with the standard in computer, and use SPSS13.0to process the data.Results1.Assessment results of radiology:before and after manipulative reduction, there was no significant difference in the comparison of volar tilting angle and ulnar inclination and radial shortening between the two groups. At4weeks, There was no significant difference in the comparison of ulnar inclination between the two groups, however, in the comparison of volar tilting angle and radial shortening,there were differences between the two groups. There was no significant difference in the comparison of the loss of ulnar deviation between the two groups, however, in the comparison of the loss of volar tilting angle and the length of distal radius, There were differences between the two groups;2.Assessment results of the Wrist function:according to Green and0’ Brien,2cases were rated as excellent and9as good and20as fair and9poor in the Group A;4cases were rated as excellent and16as good and24as fair and3as poor in the Group B. There were differences between two group, the wrist function of the group B is better than the group A.3. Assessment results of the complications:group A of40cases,8cases of complications, and32cases without any complications; group B of47cases,4cases of complications, and43cases without any complications. There was difference in the appearance of complication between the two groups.Conelusion1.Group B is better than the group A in maintaining the physiological parameters of the distal radius, In other words, the stability of group Bis better than the group A.2. Group B is better than the group A in the wrist function, Especially in the grip strength and activity.3.Group B is better than the group A in the appearance of complication, Especially in the tension vesicle and carpal tunnel syndrome and stability of distal radioulnar joint.4. According to the radiology results and wrist function and complication, Wrist fixed in dorsal extension and ulnar deviation and forearm supination is better than Wrist fixed in palmar flexion and ulnar deviation and forearm pronation. Wrist fixing in dorsal extension and ulnar deviation and forearm pronation was more in line with the biomechanical balance principle, it is relatively best fixed position.