| Objective: This study systematically analyzed the clinical effects of splint external fixation,plaster external fixation and staged use of plaster splint fixation in the treatment of elderly Colles fracture,in order to provide more safe,effective and suitable conservative treatment for elderly Colles fracture patients.Methods:Ninety elderly Colles fracture patients who met the inclusion criteria from May 2021 to November 2022 at the outpatient and inpatient departments of Jiangxi University of Traditional Chinese Medicine Affiliated Hospital were selected,with partial detachment and exclusion of data.They were randomly divided into three groups,namely the gypsum group,the splint group,and the gypsum splint group,with 30 cases each.Three groups of patients were treated with manual reduction by the same group of physicians.The splint group was treated with external fixation with a single splint for 6 weeks,the gypsum group was treated with external fixation with a single gypsum for 6 weeks,and the gypsum splint group was treated with external fixation with a gypsum for 2 weeks before being treated with external fixation with a splint for 4 weeks.Monitor and record the imaging data of palm angle,ulnar deviation angle,and radius height of three groups of patients before reduction,after reduction,and at 2 and 6 weeks of fixation;The degree of swelling in the affected limb after fracture reduction,fixation for 3 days,2 weeks,and 6 weeks;Garland Werley wrist joint function score and PRWE score when removing external fixation.Finally,statistical software SPSS Statistic25.0 was used to analyze the data obtained,and the final data was summarized and compared to compare the clinical efficacy differences between the gypsum splint group,the splint group,and the gypsum group’s treatment plans.Results: 1.The general data comparison of gender and age among the three groups of patients showed no statistically significant differences and were comparable(P>0.05).2.Comparison of palm tilt angle: There was a statistically significant difference in palm tilt angle between the three groups of patients after fracture reduction,at 2 weeks of fixation,and at 6 weeks of fixation,and the data within the group before reduction(P<0.05);After fracture reduction,there was no statistically significant difference in palm angle between the gypsum splint group,the splint group,and the gypsum group(P>0.05);When fixed for 2 weeks,there was a statistically significant difference in palm angle between the gypsum group and the splint group(P<0.05).There was a statistically significant difference in palm angle between the gypsum splint group and the splint group(P<0.05),but there was no statistically significant difference in palm angle between the gypsum splint group and the gypsum group(P>0.05);At 6 weeks of fixation,there was no statistically significant difference in palm angle between the gypsum group and the splint group(P>0.05).The difference in palm angle between the gypsum splint group and the splint group was statistically significant(P<0.05).The difference in palm angle between the gypsum splint group and the gypsum group was statistically significant(P<0.05).3.Comparison of ulnar deviation angle: There was a statistically significant difference in the ulnar deviation angle between the three groups of patients after fracture reduction,at 2 weeks of fixation,and at 6 weeks of fixation,and the data within the group before reduction(P<0.05);After fracture reduction,there was no statistically significant difference in the angle of ulnar deviation between the gypsum splint group,the splint group,and the gypsum group(P>0.05);After 2 weeks of fixation,there was a statistically significant difference in the angle of ulnar deviation between the gypsum group and the splint group(P<0.05).There was a statistically significant difference in the angle of ulnar deviation between the gypsum splint group and the splint group(P<0.05).There was no statistically significant difference in the angle of ulnar deviation between the gypsum splint group and the gypsum group(P>0.05);At 6 weeks of fixation,there was a statistically significant difference in the ulnar deviation angle between the gypsum group and the splint group(P<0.05).There was a statistically significant difference in the ulnar deviation angle between the gypsum splint group and the splint group(P<0.05).There was a statistically significant difference in the ulnar deviation angle between the gypsum splint group and the gypsum group(P<0.05).4.Comparison of radius height: There was a statistically significant difference(P<0.05)between the radius height of the three groups of patients after fracture reduction,at 2 weeks of fixation,and at 6 weeks of fixation,and the data within the group before reduction;After fracture reduction,there was no statistically significant difference in radial height between the gypsum splint group,the splint group,and the gypsum group(P>0.05);After 2 weeks of fixation,there was a statistically significant difference in the height of the radius between the gypsum group and the splint group(P<0.05).There was a statistically significant difference in the height of the radius between the gypsum splint group and the splint group(P<0.05).There was no statistically significant difference in the height of the radius between the gypsum splint group and the gypsum group(P>0.05);At 6 weeks of fixation,there was a statistically significant difference in radial height between the gypsum group and the splint group(P<0.05).The difference in radial height between the gypsum splint group and the splint group was statistically significant(P<0.05).The difference in radial height between the gypsum splint group and the gypsum group was statistically significant(P<0.05).5.Comparison of affected limb swelling: There was no statistically significant difference in the degree of affected limb swelling between the three groups of patients after fracture reduction(P>0.05);On the third day of fixation,there was a statistically significant difference in the degree of swelling of the affected limbs between the gypsum group and the splint group(P<0.05).There was a statistically significant difference in the degree of swelling between the gypsum splint group and the splint group(P<0.05),but there was no statistically significant difference in the degree of swelling between the gypsum splint group and the gypsum group(P>0.05);After 2 weeks of fixation,there was a statistically significant difference in the degree of swelling of the affected limbs between the gypsum group and the splint group(P<0.05).The degree of swelling of the affected limbs between the gypsum splint group and the splint group was statistically significant(P<0.05),while the degree of swelling of the affected limbs between the gypsum splint group and the gypsum group was not statistically significant(P>0.05);At 6 weeks of fixation,there was a statistically significant difference in the degree of swelling of the affected limbs between the gypsum group and the splint group(P<0.05).The degree of swelling of the affected limbs between the gypsum splint group and the splint group was also statistically significant(P<0.05).The degree of swelling of the affected limbs between the gypsum splint group and the gypsum group was statistically significant(P<0.05).6.Comparison of Garland Werley wrist joint function scores: After 6 weeks of fixation,there was no statistically significant difference in the Garland Werley wrist joint function scores among the three groups of patients(P>0.05).7.PRWE score: At 6 weeks of fixation,there was a statistically significant difference in PRWE scores between the gypsum splint group and the splint group(P<0.05),while there was a statistically significant difference in PRWE scores between the gypsum splint group and the gypsum group(P<0.05).Conclusion:1.The use of splint external fixation alone,plaster external fixation,and phased use of plaster and splint external fixation in the treatment of elderly Colles fractures can achieve good results,which is helpful for the recovery of wrist joint activity in patients.2.Staged use of plaster and splint external fixation for the treatment of elderly Colles fractures is more effective in maintaining palm angle,ulnar deviation angle,radius height,and swelling reduction of the affected limb than using plaster and splint external fixation alone.3.The staged use of plaster and splint external fixation for the treatment of elderly Colles fractures has a better effect on the recovery of wrist function in the later stage than the use of plaster and splint external fixation alone,which can be promoted clinically. |
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