Factors Related To The Early Wrist Function In The Elderly Patients With Distal Radius Fracture Treated With Splint

Objective:In this study,the early wrist function of the elderly patients with distal radius fracture after small splint treatment was studied,and the relevant factors affecting the wrist function were analyzed to provide the basis for clinicians to judge the prognosis and take timely preventive measures.Method:In this study,retrospective analysis was used to collect the patients who were treated in the Department of orthopedics and traumatology of Wuxi traditional Chinese medicine hospital from January 1,2018 to June 30,2019 due to distal r-adius fracture.All patients were treated with Liu's Orthopedic manipulation and plastic paper splint fixation.According to the early Gartland and werley scoring standards after the removal of fixation,they were divided into the excellent functional group and the dysfunctional group.Single factor analysis was used to screen the factors that may affect the function of wrist joint,including sex,age,injury time,injury mode,affected side,fracture type(AO classification),whether accompanied by medical diseases,whether there is tobacco and alcohol addiction,bone density(T value),degree of loss of palm angle in early stage of treatment(<100),degree of loss of palm angle in late stage of treatment(<10°),fixation Time and other 12 variables,and the use of logistic regression analysis of the variables with statistical differences,to study the factors affecting the wrist function of the elderly patients with distal radius fracture after small splint treatment.Result:(1)142 cases of distal radius fracture were included in this study,including 117 cases in excellent function group and 25 cases in dysfunction group,the excellent and good rate was 82.39%;(2)Comparing the indexes between the two groups,we found that age,gender,injury time,affected side,whether accompanied by internal diseases and whether there is a habit of smoking and drinking had little effect on the joint function(P>0.05),while the injury mode,fracture type,bone density,the degree of loss of early palm angle,the degree of loss of later palm angle and fixation time were the influencing factors that may cause wrist joint dysfunction(P<0.05),in which fracture type,injury mode,loss degree of palm angle and fixation time had significant statistical significance(P<0.01);(3)The type of fracture,the way of injury,the degree of loss of metacarpal inclination and the time of fixation were independent factors(P<0.05).Bone density and the degree of loss of metacarpal inclination in early stage were not significant in multivariate logistic regression analysis(P>0.05).Conclusion:(1)The prevalence of wrist joint dysfunction was 17.61%after the treatment of splint for distal radius fracture.(2)The complex fracture displacement caused by high energy injury is an important factor that causes the dysfunction of wrist joint after the treatment of distal radius fracture splint.During the treatment,it is necessary to restore the normal state of the wrist joint's bone structure,maintain the palm angle and reduce the fixation time under the condition of minimizing the injury.