Clinical Study Of Manual Reduction And Splint Fixation In The Treatment Of Distal Radius Fractures In The Elderly

Objective:Distal radius fracture is one of the most common types of fractures,and manual reduction and splint fixation is a common treatment.The clinical efficacy of manual reduction and splint fixation for distal radius fractures in the elderly was verified by collecting radiological data and COONEY wrist score.The changes of radiological parameters and wrist function of distal radius fractures in different age groups were analyzed,which provided a reference for further improvement of manual reduction and splint fixation for distal radius fractures.Methods:According to the inclusion criteria,72 patients with A3 type and straightened distal humerus fractures were divided into 4 groups according to age group: group A(50-59 years old),group B(60-69 years old),and group C(70 to 79 years old),D(?80 years old).All the 4 groups were treated with manual reduction splint fixation.After reset,they all met functional reset criteria and performed the same internal medicine and functional exercise.The height of the distal humerus,the angle of inclination of the humerus,and the angle of ulnar deviation before and after reduction,1 week,2 weeks,4 weeks,6 weeks,and 12 weeks were all observed,and COONEY wrist scores were performed from the fourth week.After weeks of review,the splint was removed.Statistical analysis was performed on the collected data to comprehensively evaluate the clinical efficacy of manual reduction splint fixation in the treatment of distal radius fractures in the elderly and the differences between different age groups.Results:1 Before the reduction,the height of distal humerus and the ulnar deviation angle were significantly different between the four age groups(P<0.05).There was no significant difference in the height of distal humerus and the angle of palm inclination between the four groups after reset(P>0.05).Compared with group B,the ulnar deviation angle of group B was significantly greater than that of group A(P<0.05).There was no significant difference between the other groups and group A(P>0.05).2 From the first week,the height of the distal humerus and the ulnar deviation angle were different in each group,but there was no difference in the angle of the palm.From the second week,there was a significant difference in the height of the distal humerus and the ulnar deviation angle between the D group and the A group(P<0.001),the age-related imaging parameters were significantly smaller than those of younger age,and the other two groups had no similar phenomenon compared with group A.Compared with post-reset,the P-segment height,palm angle,and ulnar deviation angle at week 6 were all <0.05,which were significantly smaller than those after reset.According to the stratified analysis by age,the height of the distal humerus and the ulnar deviation angle showed a similar trend in all age groups,all decreased significantly,but the palm inclination was similar only in the age group of 80 years or more.3 After the reduction,the height of the distal humerus,the angle of inclination of the palm,and the ulnar deviation angle increased.After the reduction,the patella decreased again and gradually stabilized from the fourth week.The distal tibial height,palm angle,and ulnar angle were associated with different time points before and after reduction.Only the ulnar deviation angle in group C did not change significantly with time(P=0.054>0.05).The total population and ages were different.In the stratified stratification analysis,the P value was less than 0.001.There was an interaction between the age group and the time point,and the interaction was P<0.001.4 The excellent rate of the overall population reached 72.2% at 12 weeks,but the good rate was worse in the middle age at different age groups.The excellent rate was100% in group A,85% in group B,66.7% in group C,and good in group D.The rate is 25%,50%,and 25%.There was a negative correlation between COONEY wrist score and age(correlation coefficient was-0.779,P <0.001),positive correlation with distal radius and ulnar deviation angle(P <0.05,and the correlation coefficient was positive),and palm inclination P> 0.05,not statistically significant.Conclusions:1 Manipulative reduction splint fixation is effective for the treatment of distal radius fractures in the elderly.It is worthy of clinical promotion.Among them,patients aged 50 to 79 years have a good prognosis.The prognosis of patients older than 80 years is inferior to that of younger patients and should be actively reviewed during the treatment.Or consider surgery.2 The distal tibial height,palm angle,and ulnar deviation angle were lost in different age groups after fracture reconstruction,and the loss of imaging parameters was different in patients of different ages.The loss of distal tibial height and ulnar deviation was significantly greater in patients over 80 years of age than those in the50-79 age group.The higher the tibia distal height,the greater the age,the greater the loss;and the difference in age at palm angle.Not significant;the difference in ulnar deviation angle between 50 and 79 years old is not significant,and the loss of patients over the age of 80 is significantly increased.3 At 12 weeks,there was a negative correlation between wrist function and age.The older the age,the lower the score of the wrist;and the positive correlation between the height of the distal radius and the ulnar deviation angle,ie,the height of the distal radius and the ulnar deviation angle after the reduction.The less the wrist function,the better the correlation coefficient of the distal radius of the humerus and the highest correlation,followed by the ulnar deviation angle.