| Objective: To compare the two treatment methods of volar locking plate and small splint for the treatment of distal radius C type fractures in elderly patients,so as to guide the rational selection of the best treatment plan for elderly patients with distal radius C fractures.Methods: a total of 120 elderly patients with distal radius C fractures treated in our department of orthopedics from June 2013 to December 2016 were selected as the subjects of this study.The group was set as locking plate group and small splint group,and 60 cases were included in each group.Two groups of patients in the fracture healing were observed,and the incidence of fracture displacement,malunion,tendon rupture,osteoarthritis,carpal tunnel syndrome and other complications were statistically analyzed.At the same time,two groups of patients were followed up for six-twelve months.The difference of palmar tilt angle,ulnar deviation angle and radius height between two groups were compared before and after treatment.The rate of functional recovery of the two groups was compared with the wrist function rating scale(Gartland).The activity of wrist joint was evaluated and compared in the state of dorsal extension,palmar flexion,radial deviation,ulnar deviation,pronation,and post rotation.According to the self-designed questionnaire,the satisfaction of the patients to the treatment effect was evaluated.Results: the average healing time of the fractures in the locking plate group was(11.3 + 2.2)weeks,and the average healing time of the small splint group was(11.8 +2.3)weeks.There was no significant difference between the two groups(t=1.217,P=0.226),and there was no statistical significance.The locking plate group of patients with various complication rate was 8.33%(5/60),was significantly lower than the small splint group 26.67%(16/60),the difference between the two groups were compared(x-= 6.559,P = 0.010),with statistical significance.The locking plate group,small splint treatment palmar angle,ulnar inclination and radial height measurement comparison showed no significant difference(P > 0.05),was not statistically significant;at the end of the follow-up,the two groups in contrast,forefoot tilt angle,ulnar inclination and radial height determination values weresignificantly increased,compared with before treatment comparison there were significant differences(P < 0.05),with statistical significance;the two group comparison between the two groups,locking plate group at the end of the follow-up palmar angle,ulnar inclination and radial height determination respectively(8.9 +2.3)%,(21.6 + 3.5)%,(10.5 + 1.6)mm,were significantly higher than that of small splint group(P < 0.05),with statistical significance.The locking plate group Gartland score excellent rate was 91.66%(55/60),was significantly higher than that of small splint group 78.33%(47/60),the difference between the two groups were compared(x2 = 4.183,P = 0.041),with statistical significance.The locking plate group of patients after treatment of back extension activity is(63.3 + 8.4)degrees,Palmer flexion is(54.6 + 7.2)degrees,radial deviation activity(21.4+ 6.7)degrees,ulnar deviation activity(28.5 + 6.3)degrees,pronation activity(76.4 + 7.1)degrees,supination activity(72.5 + 6.8)degrees were significantly higher than that of small splint group,with statistical significance(P < 0.05),with statistical significance.For the total satisfaction rate was 93.33%(56/60)patients with locking plate group,small splint group was 90%(54/60),no significant difference between the two groups(x2=0.436,P=0.509),was not statistically significant.Conclusion: in order to guide clinical form for elderly type C fracture of the distal radius the best treatment of patients,compare the specific effects of two kinds of treatment for volar locking plate and small splint,in order to ensure the satisfactory clinical effect under the premise as far as possible to improve the effect of treatment of patients with satisfaction.At the same time,the study confirmed that the volar locking plate and two kinds of treatment of small splint advantages in treatment of elderly patients with type C fracture of the distal radius,and that if there is no surgical contraindication and good general condition,it is recommended by the volar locking plate treatment,in order to obtain a good fracture reduction effect and prognosis.For the patients with high risk,contraindications or unwilling to undergo surgery,small splints can be used and satisfactory results can also be obtained. |
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