Clinical Efficacy Of External Fixation And Open Reduction And Internal Of Distal Radius Fractures In The Elderly

Objective:Distal radius fractures have been one of the most common fractures that affect the elderly.With the development of society and the aggravation of aging,the proportion of distal radius fractures is increasing.Through retrospective analysis of the clinical efficacy of manipulation and splint external fixation and open reduction and internal fixation,we can find out which way is more suitable for elderly patients with distal radius fractures.Methods:Methods from January 2016 to March 2017,the elderly patients with distal radius fractures who were treated in emergency department of orthopedics,outpatient department and ward of Department of orthopedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine were divided into splint group and operation group,30 cases in each group.There were 7 men and 23 women in the splint group,aged 62-88 years old,with an average age of 71.06±7.49 years.There were 11 men and 19 women in the operation group,aged between 60-83 years old,with an average age of 67.74±5.63 years.By comparing the two groups of patients before and after treatment,including palm inclination angle,ulnar deviation angle,radius height,wrist active motion function,wrist grip strength,kneading force and wrist Gartland-Werley score and other indicators,compare the clinical efficacy of the two treatment methodsResults:The two groups were followed up for an average of 4-6 months,with an average of 5.3 months.The general data of the two groups(sex,age,cause of injury)showed no statistical difference(P>0.05).The X-ray films of two groups showed that all fractures healed.The healing time of splint group was 11.18±0.48 weeks.The healing time of the internal fixation group was 11.33±0.57 weeks.There was no significant difference between the two groups(P=0.256>0.05).During the last follow-up,the palmar tilt angles of the splint group and operation group were(6.69±0.43)degrees,(9.56±0.44)degrees,the ulnar deviation angles were(18.11±0.79)degrees,(20.05±0.67)degrees,and the radius height were(8.13±0.40)mm,(10.65 + 10.65)mm,respectively.There were significant statistical differences between the three groups(P<0.01).Compared with the contralateral wrist joint activity in flexion and extension respectively(88.19±1.43)% and(88.41±2.01)%,ulnar deviation activities were(89.54±2.53)% and(90.58±2.46)% respectively,rotation(88.19±2.28)%,(88.44±1.64)%,respectively.The grip(87.83±1.76)% and(88.08±2.25)%,respectively,pinch force(87.96±2.74)% and(88.53±2.56)%,each data analysis showed no difference(P>0.05).The Gartland-Werley score of the wrist joint in the two groups showed that the excellent rate of the splint group and the operation group was 77% and 83% respectively,and there was no statistical difference(P=0.212>0.05).Conclusion:In the treatment of senile distal radius fractures,open reduction and internal fixation can obtain anatomic reduction than the manipulation of splint is better,but in the active wrist,grip and pinch strength and wrist score in two,there was no statistical significance,can restore good wrist function.