Clinical study on the treatment of 60cases of extended fernandez type Ⅲ fracture of distal radius with surgical indica-tions by palm pressure reduction and pressure pad splint fixation
Objective:To study the clinical effect of palm pressure reduction combined with pressure pad splint fixation on pa-tients with type Ⅲ extended distal radius Fernandez fracture with surgical indications.Method:Sixty patients with extended distal radi-us Fernandez type Ⅲ fractures with surgical indications were selected and randomly divided into two groups,A and B,with 30cases in each group.Among them,there are 17males and 43females;age range from 24to 88years old,with a median of 57years old;group A patients were treated with palm pressure reduction method and pressure pad splint fixation.Group B patients were treated with surgery,and the clinical treatment effects of the two groups were compared by comparing the three indicators of palm angle,ulnar deviation an-gle,and radius height after manual reduction and surgery,as well as using the Jakim distal radius fracture efficacy scoring system for wrist joint function evaluation after one year of treatment.Result:All 60patients were followed up for 12months.After treatment,nei-ther group of patients experienced any complications such as wrist joint misalignment,subluxation or dislocation of the lower ulnar and radial joints,or changes in osteoarthritis.The surgical patient had good postoperative incision healing,no infection,and no further dis-placement.The specific data are as follows:the palm angle(7.30±6.44,8.81±3.13,P＞0.05),ulnar deviation angle(20.93±4.55,16.19±4.12,P＜0.05),and radius height(7.57±2.23,6.63±3.04,P＞0.05)of the two groups of patients after manual re-duction and surgery.The inter group comparison shows that there is no statistically significant difference between Group A and Group B in the treatment of palm angle and radius height.However,in the treatment of ulnar deviation angle,Group A is significantly better than Group B.After 6months of treatment,According to the above efficacy criteria,clinical subjective indicators(29.20±2.07,28.40±2.70,P＜0.05),clinical objective indicators(28.90±1.95,28.80±1.86,P＞0.05),radiological examination:positive ra-dial angle(32.30±5.57,31.57±7.44,P＞0.05),radiological examination:negative,the total score(90.73±9.13,88.70±10.61,P＞0.05)showed no statistically significant difference between Group A and Group B in clinical objective indicators,radiolog-ical examination,and overall score,except that Group A was superior to Group B in clinical subjective indicators.Group A patients had 24excellent cases,1good case,4fair cases,and 1poor case,with an excellent and good rate of 83.3%;Group B patients had 20excellent cases,4good cases,3fair cases,and 3poor cases,with an excellent and good rate of 80.0%.There was no statistically significant difference between the two groups of patients(P＞0.05).Conclusion:In the treatment of extended Fernandez type Ⅲ distal radius fractures with surgical indications,the palm pressure reduction method combined with pressure pad splint fixation can achieve comparable results to surgery in restoring palm inclination angle and radius height,but its effect is superior to surgical treatment alone in restoring ulnar deviation angle.
Palm pressure methodPressure pad and splint fixationWith surgical indications for extended distal radius Fer-nandez classificationType Ⅲ fracture fracture fractureExternal application of traditional Chinese medicine
万方数据
维普
