A Comparative Study Of Two Treatment Methods Of Distal Radius Fracture Combined With Radioulnar Joint Instability

ObjectiveThrough randomized,grouped and controlled arthroscopic deep insertion repair TFCC and Kirschner wire fixation DRUJ,the clinical efficacy differences in the treatment of unstable DRF combined with DRUJ instability were analyzed,and the advantages and disadvantages of the two treatment methods were analyzed,so as to provide effective treatment for DRF combined with DRUJ instability caused by TFCC deep insertion injury.MethodsIn this study,30 patients with DRF combined with DRUJ instability in The Affiliated Central Hospital of Shenyang Medical Collegefrom October 2019 to December 2021 were collected and randomly divided into two groups according to different surgical methods.Group A was open reduction and internal fixation +ARTHROscopic TFCC repair group.Group B was open reduction and internal fixation +DRUJ Kirschner wire fixation group.By analyzing and comparing Mayo Clinic score,wrist range of motion,grip strength,DRUJ stability score,VAS score,and DASH score of upper limb function between the two groups six months and one year after operation,the efficacy of two different surgical methods in the treatment of distal radius fracture with inferior radioulnar joint instability was discussed.Results1.There were no statistically significant differences in gender,age,affected side,clinical manifestations and signs,and AO typing between group A and group B（P>0.05）,indicating comparability.2.There was no significant difference in Mayo Risk score between group A and group B six months and one year after surgery（P>0.05）.3.VAS score of group A half year and one year after surgery was lower than that of group B,the difference being statistically significant（P<0.05）.4.DRUJ scores of group A half year and one year after surgery were higher than those of group B.The difference was statistically significant（P<0.05）.5.There was no significant difference in DASH scores between group A and group B six months and one year after surgery（P>0.05）.6.The grip strength of group A half year and one year after operation was higher than that of group B.The difference was statistically significant（P<0.05）.7.There was no significant difference in wrist range of motion between group A and group B six months and one year after surgery（P>0.05）.ConclusionTwo different surgical methods for DRF combined with DRUJ instability can achieve satisfactory results.DRUJ Kirschner wire fixation is simpler,shorter operation time,smaller incision,relatively low surgical difficulty,but postoperative VAS,grip strength,DRUJ stability recovery is lower than arthroscopic TFCC repair;Compared with DRUJ kirschner wire fixation,arthroscopic TFCC repair has more steps and more complex technology,making wrist arthroscopic operation more difficult.The recovery of VAS,grip strength and DRUJ stability after wrist arthroscopy was better than that of DRUJ Kirschner wire.