| Purpose:To compare the clinical effects of the splint, plaster, external fixation in the treatment of AO type-A3 distal radius fractures.Methods:In Fujian Province Fuzhou City the second hospital orthopedic, from September 01 2014-September 012015, diagnosis and treatment of AO type-A3 type fractures of the distal radius fracture patients, using a completely randomized grouping method,95 patients were divided splint group:14 patients were male and 17 female patients, age 50.38+4.12 years old; plaster group:14 cases of male, female 18, age 51.24+3.23 years old; external fixation group:15 cases of male, female 17, age 49.50+3.28 years old. Observing the index of pain score, swelling measurements, complications, fracture position (palmar tilt, ulnar deviation, radial height, ulnar radial dislocation), bone density detection, joint activity degree after reduction of the instant, the 4 days,7 days,14 days,28 days and 6 weeks, the 8 weeks, measuring Cooney wrist function score and bone density in 3 months and half indicators, comparative study, using Statistics PASW 18 statistical software analysis.Results:According to the requirements of continuous follow-up in 90 cases,5 cases were shedding. Fourth days later after reduction external fixation group alleviating swelling rapidly, pain reactions were statistically significant.7 days after fracture (see Table 6), the volar tilt, ulna deviation, radial height of the splint and plaster group were reduced, io be adjusted in accordance with the clinical standards. The fracture position of the external fixation group is unchanged, the plaster group of ulnar deviation shift than the rest of the group of meaningful, splint group of swelling measurements than the other two groups meaningful. After 14 days (see Table 7), the volar tilt,ulnar deviation, radial height of the splint and plaster group continue to decrease,because fracture time is 2 weeks, so no adjustment. VAS score of the plaster than the other two groups, splint group swelling measurements is meaningful than the other two groups, too slow going down. Bone fracture after reduction of the 28 days, splint group swelling measurement value is compared with the other two groups of meaningful, plaster group in radial height, ulnar deviation, palmar tilt shift than the other two groups, suggested that plaster easy to loosen, the splint group compared with the other two groups in the functional activities, significant differences. Six weeks after fracture, the wrist bone density around the inspection, splint group of low bone mineral density measurement, difference was statistically significant compared with the other two groups. At 8 weeks pressure sores, limited thumb outreach, median nerve irritation, ulnar radial subluxation are the complications after the fracture.3 months after the fracture to Cooney wrist joint function score, splint group score high, comparing the difference of the rest of the group was statistically significant; and when the review of bone density, there was no statistically significant difference comparing the three groups. Six months after the fracture again Cooney wrist joint function score, there was no statistically significant difference comparing the three groups.Conclusion:1. In the process of splint fixed,4 days prevent blisters,7 days control shift,14 days of prevention and treatment of pressure sore is the new experience in the study summarized, rational use of splint can effectively reduce the complications and the good effect is obtained.2.In the study, the definition of "longitudinal squeeze pressure" is defined as the radius height loss.There is no reaction furce to the "longitudinal squeeze pressure", which is the mechanical defect of the splint, proposed to increase the fixed structure of the first palm wrist joint. It has a certain relationship with swelling and osteoporosis of the splint group and plaster group.3. Summarized the treatment of AO type-A3 distal radius fractures:preferred splint fixation, the plaster poor stability, the mechanical analysis of the external fixation is reasonable, can choose to use, especially for who can’t cooperate actively adjust splint elasticized. |
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