The Postoperative Efficacy Of The Dorsal Surgical Approach To The Treatment Of Intra-Articular Distal Radius Fractures

Objective:Clinical application on steel plate internal fixation in the treatment of intra-articular distal radius fractures acquire good clinical results.Open reduction and internal fixation with steel plate technology has been widely used in clinical practice.But at the moment there is no clinical study of large samples that was given for the two kinds of surgical approach for the intra-articular distal radius fractures and there is no strong evidence of clinical research that shows the relative merits of the two approaches.There is also no standard treatment for different types of fractures.At present,when it is generally believed that the treatment of intra-articular distal radius fractures,the selection of open reduction steel plate internal fixation technology can direct the exposed fracture terminal,and in the direct view of the dislocation of the fracture block,reset dislocated fracture under direct vision block,restore the articular surface of the distal,limb mobility of the wrist and grip strength is restored.However,there is no consensus on which surgical approach can be used to treat the distal radial instability fracture.With the rapid development of medical technology,doctors should have their own unique insight into this type of fracture.It can provide patients with a reasonable and minimal surgical procedure.It will eventually lead to a good therapeutic effect.Collectted the ward and emergency patients that come from Third Hospital of Hebei Medical University and The hospital of Xuanhua Steel Company to complete Follow-up investigation and retrospective analysis,comparative analysis before and after treatment and two times removed after internal fixation,and the tutor's clinical experience summary.We hope to provide the basis and help for the selection of treatment options for intra-articular distal radius fractures.Methods:A total of 60 cases of hospital emergency,outpatient and ward were collected in the third hospital of hebei medical university and The hospital of Xuanhua Steel Company.The above patients who is Intra-articular distal radius fractures were all accepted the surgical treatment.Divided into A,B group of two.Patients in group A were treated with volar approach,a total of 38 patients,including male patients in 26 cases,female patients in 12 cases;Patients in the B group were treated with dorsal approach,a total of 22 patients,including male and female,9 male patients,12 female patients.Respectively compared the operation time,dorsal and volar two surgical methods need fracture healing time required,the fracture of wrist function after healing and complications were compared and analyzed statistically.Result:1.The results of the studyIn 60 patients with intra-articular distal radius fractures,the surgical approach was divided into two groups: A and B,using Volar surgical approach in group A and group B with posterior surgical approach.Within the same group before surgery,with open reduction and internal fixation after the operation and removal of internal fixation after comparing after radiological examination: height of RADIUS,radial and ulnar deviation wrist Palm dip significantly,there was statistical significance(P<0.05).Between the two groups after surgery and after removal of internal fixation comparative height of RADIUS,radial and ulnar deviation wrist Palm dip no statistically significant difference between(P>0.05).Two ways of surgical approach until the removal of internal fixation of fracture healing followed by Gartlandwereley wrist function score and grip strength detected no statistically significant difference(P>0.05).The treatment of intra-articular distal radius fractures should be achieved.According to the displacement of the fracture direction on appropriate surgical approach,reduction and fixation easy operation.The operation should be careful and gentle to avoid soft tissue damage such as nerves,blood vessels and tendons.Should try to achieve anatomical reduction of the dislocation fragment,restoring the original anatomical and mechanical transmission of the wrist joint.Postoperative check regularly in film,according to review the film,guiding patients limb function exercises,restoring function of daily living needs.2.Surgical curative effect evaluationPostoperative date pursuant to the provisions of standard LAT x ray wrist through Imaging observation of fracture healing,determine the specific healing of fractures of the distal radius and decided to implant removal time.Regular follow-up to observe and record the patient to guide functional exercises of the wrist and,until the good recovery of wrist function.Pain in some patients until the implants removed after complete remission.Only 5 patients at the time of physical pain,limb grip strength recover better than before surgery significantly improved on average to the contralateral 79.1%,most patients with wrist flexion and extension activities,ulnar deviation of motion,radial deviation of motion and forearm rotation is good.5 have only slightly restricted.3.Wrist range of motion and strength evaluation of measuring resultsFractures of the distal row removal of implant bone healing,postoperative check wrist movement and grip force relative to before surgery has been significantly improved,to compare measurement results,there was significant.(P<0.05)?Conclusion: In the treatment of intra-articular distal radius fractures,two surgical approaches can be used to achieve a good clinical effect.How to restore wrist function in patients with the best treatment?It should be based on the individual patient's condition and select the most convenient to observe of fractures.As for surgical complications,intra-articular distal radius fractures caused by high energy damage mechanism were severely damaged,and the majority of patients were not left after surgical treatment.And after the treatment a few patients will be impacted on daily life but it had little effect.