| ObjectivesConduct a preliminary study on the impact of sustained retractor on preventing radial shortening after manipulative reduction of distal radius fracture, and evaluate its clinical efficacy.MethodsFrom March of2013to January of2014, Orthopaedic Emergency and Outpatient Department of Guangdong Provincial Hospital of Traditional Chinese Medicine selected40patients with distal radius fracture according to standards, and randomly divided them into experimental group and control group. Both groups experienced manipulative reduction and external fastening with splint. After that the experimental group kept wearing sustained retractor to drag the end of fracture till the removal of external fixation; the control group was simply treated with manipulative reduction and external fastening with splints; both groups were measured and recorded the radial height, radial palmar tilt, radial ulnar inclination of the broken limb after the reduction and removal of the splint; calculated and recorded the missing values of the radial height, palmar tilt, ulnar inclination of the broken limb; observed, measured and recorded the VAS pain scores, wrist swelling and palm swelling on the day of the fracture reduction, the third day after the reduction, and each week of the first1-6weeks; calculated and recorded the clinical healing time of the fracture; assessed and recorded the Gartland-Werley wrist scores and ranking of the broken limb after twelve weeks of fracture reduction; then conducted a statistical analysis, in order to comprehensively assess the clinical effects of sustained retractor on preventing radial shortening after distal radius fracture. Result1. The study selected40cases, including10males and30females, and4cases ceased (2males and2females),36cases fully participated in the study, including8males and28females. Divide them into Experimental group with19cases, and control group with17cases.2. In the prevention of radial shortening:①The mean value of both groups’radial height after the removal of splint is greater than that in fracture reduction,P<0.05, with statistical significance.②After the fracture reduction, the mean values of both groups’radial height have no statistical significance, P>0.05. But at the time the fracture is clinical healed, the mean values of the experimental group’s radial height is greater than that of the control group, P<0.05, with statistical significance.③The missing values of the experimental group’s radial height inclination below those of the control group, P<0.05, with statistical significance.3. The impact on the ulnar inclination:After the fracture reduction, the mean values of both groups’ulnar inclination have no statistical significance, P>0.05. But at the time the fracture is clinical healed, the mean values of the experimental group’s ulnar inclination is greater than that of the control group, P<0.05, with statistical significance. The missing values of the experimental group’s ulnar inclination below that of the test group, P<0.05, with statistical significance.4. The impact on the palmar tilt:After the fracture reduction and at the time the fracture is clinical healed, the mean values of both groups’palmar tilt have no statistical significance, P>0.05.5. In terms of pain relief, there is no significantly statistical difference in the VAS pain mean values between the two groups during the entire follow-up, prior to the fracture reduction, three days after the fracture reduction or each follow-up visit in1-6weeks.6. In terms of detumescence:①The swelling of transverse wrist crease and the swelling of transverse palm crease between the two groups have no significantly statistical difference during the entire follow-up.②Prior to the fracture reduction, and2-6weeks after the reduction, the mean values of the swelling of transverse wrist crease and the swelling of transverse palm crease between the two groups have no statistical difference, P>0.05. On the third day and in the first week after the fracture reduction, the mean values of the swelling of transverse wrist crease and the swelling of transverse palm crease in the experimental group are greater than those in the control group, with statistical significance.7. In terms of wrist function:The Gartland-Werley wrist scores of the broken limb after twelve weeks of the fractures reduction in the experimental group and the control group, are5.58±3.49and7.18±5.77respectively, the mean values between the two groups have no statistical significance, P>0.05. The ranking comparison of Gartland-Werley wrist scores of the broken limb after twelve weeks of the fractures reduction between the two groups employs rank sum test with two independent samples, P>0.05, without statistical significance.8. The fracture clinical healing time of the experimental group and the control group is5.84±0.83week and6.41±0.62week respectively, P<0.05, with statistical significance. The mean value of clinical healing time in the experimental group is shorter than that in the control group.9. One case had blisters on the back of the wrist in the experimental group, considering caused by the friction between the wrist fixing strap of the sustained retractor and the skin, and could be healed by treatment. This did not lead to serious consequences to the patient, and this patent may continue with the study after treatment.ConclusionSustained retractor cannot completely prevent the loss of the radial height after the distal radial fracture. But the use of sustained retractor can effectively reduce the loss of radial height. |
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