Clinical Study Of Two Surgical Methods For Distal Radius With Ulnar Styloid Fracture

BackgroundDistal radial fracture is a common fracture of the upper extremity of the adult,accounting for about 17% of the total body fracture,and most occur in the elderly.In the early stage of modern medicine,the understanding of distal radius fractures is not profound.Usually,manual reduction and external fixation are used for treatment.With the development of society,in contemporary medicine,the incidence of distal radius fractures is increasing,the causes of the disease are also increasing,and the age is also tending to be younger.Because of the development of transportation and construction,many distal radius fractures caused by high energy damage have appeared,accompanied by ulnar styloid fracture,or distal radioulnar joint injury,wrist dislocation,etc.Nowadays,for such distal radius fractures,how to better treat such fractures and better restore the function of the wrist joint is the main purpose of clinical treatment.Usually,simple closed distal radius fractures are selected for open reduction and volar plate fixation.For the distal radius with ulnar styloid fractures,the distal radioulnar joint and wrist joint damage will be involved to varying degrees.In the past experience,depending on the degree of injury,simple palmar plate fixation or volar plate combined with ulnar styloid screw Fixation,which treatment method can be used to better treat the distal radius with ulnar styloid fractures,there is no clear conclusion.ObjectiveTo evaluate the efficacy of simple volar plate and volar plate combined with ulnar styloid screw in the treatment of distal radius with ulnar styloid fractures,and to provide a clearer diagnosis and treatment for the treatment of distal radius with ulnar styloid fractures.MethodRetrospective analysis of 83 patients with distal radius fractures and ulnar styloid fractures from May 2015 to August 2017 in the Department of Orthopaedics,First Affiliated Hospital of Zhengzhou University,40 males and 43 females,including the volar plate 43 patients with ulnar styloid screw fixation(group A),20 males and 23 females;40 patients with simple plate fixation(group B),20 males and 20 females.The summary of the patients,and postoperative fracture reduction quality(postoperative palm tilt angle and ulnar angle recovery),postoperative complications were compared between the two groups,and the recovery of wrist joint function was evaluated according to the Gartland-Werley wrist function scoring system.ResultsAll the 83 patients underwent surgery successfully.All patients were followed up for an average of 9 months(7-14 months).All the fractures were healed after X-ray examination.There was no plate screw fracture,no deep and incision infection.According to the last review X-ray,the palm tilt angle of the two groups(12.239±0.600 in group A,13.136±0.432 in group B)and the ulnar angle of the two groups(21.476±0.583 in group A,22.351±0.315 in group B)were compared,the palm tilt angle P>0.05,ulnar angle P>0.05,the difference between the two groups was not statistically significant;all patients were based on the last review.All patients were evaluated for wrist function based on the last review of the Gartland-Werley wrist function score.The results were as follows: group A(2.344±0.411)was excellent in 35 cases,good in 5 cases,fair in 3 cases,and excellent and good rate was 93.02%;group B(2.800±0.506)was excellent in 31 cases and good in 4 cases.fair in 5 cases,the excellent and good rate was 87.50%;the difference between the two groups was P>0.05,the difference was not statistically significant;The proportion of patients with ulnar side pain was 4.65% in group A and 20.00% in group B.P<0.05 was compared between the two groups,and the difference was statistically significant.ConclusionsThe volar plate combined with the ulnar styloid screw fixation of the distal radius with ulnar styloid fractures compared with the simple volar plate treatment,both can better restore the radius height,palm tilt angle,ulnar angle,and can achieve a satisfactory reduction effect.The former has a better rate of superiority than the latter,and the proportion of ulnar side pain is significantly lower than that of the latter,which can restore wrist function more efficiently.