| Objective: To compare the short-term and mid-term effects of open reduction and internal plate fixation and external fixation for type C fracture of distal radius.Methods: A total of 60 patients who were diagnosed with type C fracture of the distal radius and were treated in the affiliated hospital of Inner Mongolia Medical University from September 2017 to February 2019 were collected.According to the different surgical methods,it is divided into a steel plate internal fixation group(VLP group)and an external fixation group fixation group(EF group).There were 33 patients in the VLP group,with an average age of(56.48 ± 12.92)years,10 males,23 females,13 right wrists,20 left wrists,8 car accident injuries,and 25 fall injuries.There were 27 patients in the EF group,with a mean age of(57.78 ± 13.45)years,7 males,20 females,18 right wrists,9 left wrists,6 car accident injuries,and 21 fall injuries.The follow-up time was 1 year after surgery.There were no significant differences in gender,age,and injury factors between the two groups(P> 0.05).The time of surgery was recorded,and palmar tilt,ulnar inclination,and radial styloid height were measured and recorded on radiographs of the wrist at 3 days,3 months,and 1 year after operation.The time of fracture healing was recorded in both groups.Gartland-Werley wrist function scores were used to score patients with residual wrist deformity,pain,and mobility at3 months and 1 year after surgery,respectively.SPSS22.0 statistical software was used for statistical analysis of the data.P <0.05 was considered statistically significant.Results: Patients in both groups were followed up for 12 months.1.The operation time in the EF group was(25.37 ± 1.11)minutes,and the VLP group was(61.73 ± 4.78)minutes.The operation time in the EF group was significantly shorter than that in the VLP group,and the difference was statistically significant(P<0.05).The fracture healing time in the EF group was(12.74 ± 1.10)weeks,and that in the VLP group was(15.52± 1.20)weeks.The fracture healing time in the EF group was shorter than that in the VLP group,and the difference was statistically significant(P<0.05).Among the postoperativecomplications,in the VLP group,there were 1 case of median nerve palm branch injury,2cases of carpal tunnel syndrome,and 1 case of traumatic arthritis,the complication rate was12.12%.In the EF group,there were 2 cases of nail infection and 1 case of joint stiffness,the complication rate was 11.11%.The complication rate in the VLP group was higher than that in the EF group,but the difference was not statistically significant(P>0.05).2.At 3 days,3 months,and 1 year after operation,palmar tilt,ulnar inclination,and radial styloid height of the VLP group were better than those of the EF group,but the differences were not statistically significant(P> 0.05).3.At 3 months after operation,Gartland-Werley score of wrist function in two groups of patients.The patients in the VLP group were(4.88±2.55)points and the patients in the EF group were(6.63±2.71)points.The difference between the two groups was statistically significant(P <0.05).The VLP group scored 8 excellent and 19 good,with an excellent and good rate of 81.8%,and the EF group scored 3 excellent and 18 good,with an excellent and good rate of 77.8%.Most of the patients in both groups recovered well in wrist function,and the excellent and good rate of wrist function was higher in VLP group than in EF group,but the differences were not statistically significant(P>0.05).4.At 1 year after operation,Gartland-Werley score of wrist function in two groups of patients.The patients in the VLP group were(5.67±2.59)points and the patients in the EF group were(6.15±2.32)points.The difference between the two groups was statistically significant(P<0.05).The VLP group scored 6 excellent and 21 good,with an excellent and good rate of81.8%.The EF group scored 3 excellent and 20 good,with an excellent and good rate of85.2%.The EF group had a better wrist function than the VLP group,but the differences were not statistically significant(P>0.05).Conclusion: 1.The results show that both internal fixation and external fixation with steel plates can achieve good results in treating type C fracture of the distal radius.2.The operation time and fracture healing time of the external fixation group were shorter than those of the steel plate internal fixation group,and the complication rate was lower.3.Compared with the external fixator,the internal fixation of the steel plate is more conducive to the recovery of wrist function in the short term,and there is less loss of postoperative reduction. |
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