Comparative Study On The Treatment Effect Between Closed Reduction With The Splint Fixation And Open Reduction With The Plate Internal Fixation In Type C Of The Elderly Fractures Of The Distal Radius

Objective:Through the comparative analysis of conservative treatment and surgical treatment of elderly of type C fractures of the distal part of the radius of the wrist joint function recovery and complications before and after the situation,to study the treatment elderly of type C fractures of the distal part of the radius of the choice.METHODS:It is a retrospective analysis from January 2015 to January 2016 in Affiliated Hospital of Shandong University of Traditional Chinese Medicine of old age of 60 patients with type C fractures of the distal part of the radius.These patients were divided into two groups by random number method,one is the conservative group(Manipulative reduction and small splint external fixation),the other is surgical group(Open reduction and internal fixation).There are 30 patients in each group.Clinical healing time were observed before and after reset,fracture on the imaging examination of wrist volar tilt angle,ulnar deviation angle and axial shortening of radius.Compare the Cooney wrist score of two groups of patients in the last follow-up,and the complications of postoperative and intraoperative were statistically analyzed and compared.Results:1.Two groups of patients were followed up for 9 to 12 months,average 10.5 months.There is no surgical incision infection and delayed healing complications.Conservative group and surgical group fracture healing time was not statistically significant.The conservative group(10.41 + 1.205)weeks,the surgical group(10.86 + 1.320)weeks.P=0.327 > 0.05,not statistically significant.2.The three parameters for evaluation of conservative groups and surgical groups: volar tilt angle,ulnar deviation angle and axial shortening of radius.When we examine the treatment of two groups by T test,we can get the conclusion: P values > 0.05 before treatment,and no statistical significance;P values > 0.05 after treatment,and no statistical significance;P values < 0.05 at the last follow-up,and there is statistical significance.The surgical groups’ clinical effect is better than the conservative groups.3.At the time of the last follow-up,The two groups’ Cooney wrist score results through statistical tests,P value is less than 0.05,with statistical significance;excellent in 5 cases,good in 18 cases,acceptable in 5 cases,poor in 2 cases;surgical group: excellent in 6cases,good in 115 cases,acceptable in 7 cases,poor in 2 cases.The P values < 0.05,with statistical significance.Conclusion:1.The conservative group and surgical group were no significant difference in fracture healing time,and there was no significant difference in the number of complications.2.Statistically,the recovery of the surgical group of wrist joints’ palm inclination,ulnar deviation,axial shortening of radius were better than that of the conservative group.3.On the situation of follow-up time 9 to 12 months,average follow-up time 10.5 months,the last follow-up’s curative effect between surgery and conservative,the volar tilt angle,ulnar deviation angle and axial shortening of radius,is an obvious difference.Surgical group is superior to the conservative groups.4.Surgical effect is better than conservative treatment in type C of the elderly fractures of the distal radius.However,some elderly people did not tolerated it because there is still a large trauma in operation.So we should choose the right way according to patients’ health status.