| Background and Objection:Distal radius fracture one of the most common fractures of the whole body, as well as a common fracture of emergency treatment, and according to the data, it accounts for about 17%of emergency fracture. In the human body joint motion, the active ratio of the wrist joint rate is higher with more sensitive mobility, which undertakes the larger physical activity. So the recovery and improvement requirement of motor function is higher after the wrist joint injury, therefore, we need to study pathogenesis and operation method of the Barton fracture. With the deep study of distal radius, many results show that the Distal radius fracture closely related to osteoporosis. Some researchers think that osteoporosis is the important pathologic basis of Barton fracture, and also determines the severity of the fracture.There are many treatment methods for Barton fracture; with knowing more about the biomechanics, sclerotin change and myodynamia change, we have a deeper understanding of the relative stability of fracture, thus constantly developing new tools to restore the stability in clinic. With the development of various fixation technology, more and more patients with Barton fractures accept the operative treatment, including the elderly patients. The past experience shows us that for elderly patients, even malunion, there is little impact on the wrist joint function, and will not seriously affect their life. Although more and more patients accept surgery, it is a pity that there is few randomized controlled trial about the Distal radius fracture without enough evidence for clinical doctors to refer. Choosing the surgery or conservative treatment and what kind of surgery shall be adopted are the problems needing to be studied further.This paper aims to further explore the relationship between Distal radius fracture and osteoporosis, evaluate the difference of two kinds of treatments in prognosis function and fracture healing form, and explore the better way for the treatment of Barton fracture, providing more clinical research basis for the treatment of Barton fracture.Method:Investigate the relationship between the Barton fractures and BMD:select 45 patients with Distal radius fracture admitted in our hospital form January 2010-January 2013, (diagnostic criteria and inclusion criteria is as follows), and select 45 patients without Distal radius fracture of the same age, measure the lumbar vertebra (L2-4 centrum), left wards triangular bone density with dual energy X-ray BMD sonometer. Divide them by age (40-50,51-60, and 61-70 age group), and analyze the relationship between the BMD and fracture among groups and within groups.Comparative analysis of the curative effect of plate internal fixation and plaster external fixation for type C fracture:27 patients with type C Distal radius fracture out of 53 adopt surgical treatment (9 cases for dorsal P plate,18 cases for volar LCP). Evaluate the therapeutic effect in the 6 weeks,3 months,6 months and 12 months before and after the operation, adopt PRWE score, DASH score, motion of wrist joint to evaluate the curative effect and function, and at the same time carry out the imageological examination to evaluate the iconography prognosis.Result:Investigate the relationship between the Distal radius fracture and BMD:the umbar vertebra BMD and collum femoris MBD of the patient with Distal radius fracture in three groups are significantly lower than that of the control group of the same age.Comparative analysis of curative effect of plate internal fixation and plaster external fixation for type C fracture:in the aspect of the radiological evaluation, PRWE score, the internal fixation group is better than the plaster fixation group, and volar locking group is better than the other two groups. But there is no obvious difference in the DASH score. There is no obvious difference in the complication between two groups.Conclusion:The results show that the Distal radius fracture caused by light trauma for 40-70-year-old patients is associated with low BMD, which is the forerunner of osteoporosis. For such patients, especially the younger patients, it is advised that they should have the BMD test regularly, so that they can prevent and treat the osteoporosis as soon as possible, preventing the secondary fracture.PRWE score of internal fixation group is obviously lower than that of plaster group, and the merit of volar LCP is more apparent, so type C Distal radius fracture should be treated with internal fixation, but the plaster fixation is also effective for elderly patients. |
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