Clinical Observation Of Traditional Chinese Medicine Orthopedic Manipulation Combined With Reduction By Small Incision And Internal Fixation For The Type B And Type C1 Distal Radius

Objective: The purpose of this subject is to compare the effect of the traditional Chinese medicine orthopedic reduction method under the anesthesia on the treatment of distal radius type B and C1 fractures with small incision and reduction plate internal fixation,and to evaluate the treatment of distal radius The clinical effect of the fracture provides a new idea for the treatment of this fracture.Methods: The cases in this subject are all patients from the Department of Traumatology and Orthopaedics of the Second Fuzhou Hospital Affiliated to Xiamen University from December2018 to December 2019.60 patients with distal radius fractures all met the inclusion and exclusion criteria,and were numbered according to the order of time they were admitted to the hospital system.All were divided into group A and group B according to the random method of the digital table,corresponding to the treatment group and the control group,both groups were 30 cases.The two groups of patients were all under general anesthesia.The difference was that after the anesthesia was successful in the treatment group,the towels were disinfected,and under the condition of complete painlessness and resistance,TCM orthopedic manipulative reduction was performed first,assisted by fluoroscopy,manipulative maintenance or temporary fixation of Kirschner wire,and then small Incision steel plate internal fixation;the control group only directly used a small incision to cut the steel plate for internal fixation.The pain score,swelling degree,palm tilt angle,ulnar tilt angle and radius length,X-ray fluoroscopy time,operation time,bleeding volume,and wrist joint function score were used as clinical observation indicators before and after treatment.The difference between the group and the control group and before and after treatment in each group,and the incidence of adverse events after surgery was counted.Results: The cases in the treatment group and the control group were carried out according to the doctor's instructions,and were followed up within 3 months after the operation.In the comparative study of VAS scores,the treatment group was better than the control group,with statistical significance(P <0.05);in terms of the degree of swelling,there was no significant difference between the two groups,and there was no statistical significance(P> 0.05);At 3months after surgery,the results of the wrist joint function scores of the two groups were equivalent,with no statistical significance(P> 0.05);but the palmar inclination angle,ulnar angle,and radius length had significant differences before and after surgery,with statistical significance(P <0.05),the relevant imaging indexes between and within the two groups of patients were equivalent at 1 and 3 months after surgery,and were not statistically significant(P> 0.05);while the operation time of the treatment group was shorter than that of the control group,X-ray The number of fluoroscopy was more than that of the control group,which was statistically significant(P <0.05);there was no significant difference in the amount of surgical bleeding between the treatment group and the control group,and there was no statistical significance(P> 0.05).Only 3 of the 60 patients had poor wound healing,2 had median nerve injury,and the remaining patients had no other serious complications or accidents.Conclusion: For the treatment of type B and C1 fractures of the distal radius,TCM orthopedic reduction,assisted by fluoroscopy,manual maintenance or temporary fixation with Kirschner wire,and then small-incision plate internal fixation are performed under general anesthesia without pain and resistance,Can effectively use the soft tissue hinge to traction torestore the fractured end,reduce intraoperative dissection,the operation is faster and less invasive,the risk is low,the curative effect is good,and it will be a better choice.