Therapeutic Effect Of Internal Fixation With External Fixation And External Fixation For The Treatment Of Comminuted Fracture Of The Distal Radius

Objective: Rehabilitation effect of comparison of plate and external fixation for the treatment of comminuted fracture of distal radius.Methods: Sixty-four patients with comminuted fracture of distal radius treated with plate and external fixator from June 2014 to December 2017 were retrospective analyzed.According to the surgical approach,it can be divided into two groups: steel plate internal fixation group and external fixation support group.The plate group(n=34)was followed up for(19.15±8.92)months,The average age was(49.12±13.21)years old,19 males,15 females,12 left-handed,22 right-handed,8 fall injuries,and 26 car accidents,the external fixator group(n=30)was followed up for(17.9±11.34)months,The average age was(47.57±10.29)years old,16 males,14 females,20 left-handed,10 right-handed,7 fall injuries,23 car accidents.The Gartland-Werley score,COONEY score,DASH score,range of motion of the wrist joint,grip strength and distal humeral imaging results were compared.Linear regression analysis was used to analyze the correlation of ulnar variation and humeral height,with forearm pronation and wrist joint deviation.Results were statistically analyzed using SPSS22.0.Results: Sixty-four patients successfully completed the operation and were followed up.At the latest follow-up,in the plate group,Gartland-Werley score: excellent in 21 cases,good in 13 cases.COONEY score: excellent in 20 cases,good in 12 cases,moderate in 2 cases.DASH score was 5.744±4.055.In the external fixator group,Gartland-Werley score: excellent in 24 cases,good in 6 cases.COONEY score: excellent in 24 cases,good in 6 cases.DASH score was 4.872±3.174.There was no significant difference between two groups.Fracture rehabilitation effect: there was no significant difference in palmar flexion,dorsal extension,squatting,supination grip strength ulnar variation,thickness or palm tilt between two groups.The external fixatior group had a larger deviation,pre-rotation angle,tibial height and sacral stem tip inclination than the plate group(P=0.000).The radical width in the external fixator group was significantly smaller than that in the plate group(P=0.001).The inclination of the sacral stem tip had an influence on the pre-rotation angle in the external fixator group(P=0.018).The pronation angle became large with the inclination of the sacral stem tip increasing.Conclusion: 1.Both open reduction with internal fixation and closed reduction with external fixation can achieve satisfactory results in patients with comminuted fracture of distal radius.2.Closed reduction external fixation technique shows superiority in patient wrist deviation and pronation function.