1.Therapeutic effect of conservative treatment on distal radius fracture as compared with surgical treatment
Xinhua JIANG ; Guoping YU ; Weixing DONG ; Jiqiu PENG ; Hao PANG ; Huilun XIAO ; Anming LYU ; Bo XU
Journal of Navy Medicine 2015;(4):321-323,328
Objective To compared and analyze the therapeutic effect of conservative treatment on distal radius fracture as compared with surgical treatment,so as to provide evidence for the diagnosis and treatment of distal radius fracture.Methods A retro-spective analysis was made on the clinical data of 162 patients with distal radius fracture treated in our hospital from January 2005 to De-cember 2011.In accordance with the different treatment methods,the patients were divided into 2 groups:the conservative treatment group and the surgical treatment group.The patients in the conservative treatment group consisted of 95 patients,including 58 males and 37 females,with an age range between 21 and 64,averaging 52.8 years old.There were 47 cases of extra-articular fracture (type A fracture),28 cases of partial intra-articular fracture (type B fracture)and 20 cases of complicated intra-articular fracture (type C fracture).They were fresh closed fractures and were sent to hospital within 8 hours after fracture.After manual reposition,they had plaster splint for 4 to 7 weeks.The surgical treatment group contained 40 male and 27 female patients,with an age range between 22 and 65,averaging 53.1 years old.The control group included 31 type A fractures,22 type B fractures and 14 type C fractures.T-form steel plates were used for fixation of fractures after surgical reposition.Medical follow-ups were performed 12 to 41 months after surgery (averaging 14.5 months),and therapeutic effects were observed by using reposition scores and function test scores.Results Of the
162 patients,139 patients fulfilled the 12 to 41-month (averaging 14.5 months)medical follow-ups,including 80 cases in the conser-vative treatment group and 59 cases in the surgery group.With regard to function test scores,35 cases were of excellent rate,20 cases were of good rate and 4 cases were of moderate rate for the surgical treatment group.As for the conservative treatment group,45 cases were of excellent rate,25 cases were of good rate,8 cases were of moderate rate and 2 cases were of poor rate.Excellent rates for type A,B and C fractures accounted for 89.47% (17 /19),94.12% (16 /17)and 92.31% (12 /13)respectively,all with satisfactory therapeutic results.As for conservative treatment group,excellent rates for type A,B and C fractures accounted for 94.59% (35 /37), 91.67% (22 /24)and 68.42% (13 /19)respectively.There was no statistical significance in the reposition scores of type A and B fractures and function test scores,when comparisons were made between the surgical and conservative treatment groups(P >0.05). However,the reposition scores of type C fracture and function test scores for the surgical treatment group were obviously superior to those of the conservative treatment group,with statistical significance (P <0.01).Conclusion As for type A and B fractures,manual reposition plus external splint fixation and surgical reposition plus internal fixation could all achieve relatively good therapeutic results, whereas surgical reposition plus internal fixation for type C fracture could achieve better results.

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