Clinical study on the combined volar dorsal approach with bone graft and plate internal fixation for the treatment of elderly type C distal radius fractures

doi:10.3877/cma.j.issn.2096-0263.2021.05.006

Abstract

Abstract:

Objective

To investigate the clinical effect of combined volar dorsal approach bone graft plate internal fixation and external fixation in the treatment of of elderly type C distal radius fractures.

Methods

85 patients with AO C type distal radius osteoporotic fractures in our hospital from January 2015 to January 2020 were selected as the research objects. According to the different treatment methods, all the subjects were divided into two groups: open reduction and plate internal fixation group (ORIF) and closed reduction and external fixation group (CREF). The operation time, fracture healing time, hospital stay, postoperative complications, postoperative imaging, wrist range of motion and garland and werley score of wrist function were observed and compared between the two groups.

Results

All patients were followed up for an average of (15±4) months. The operation time of CREF group was (41±10)min, fracture healing time (9.2±2.7)w, hospitalization days (4.1±1.0)d was better than ORIF Group [(72±9)min, (12.0±2.5)w, (7.4±1.2)d], (P<0.05). In the comparison of postoperative imaging between two groups, the collapse degree of joint surface in ORIF group was (0.7±1.3)mm, palm inclination (10.5± 1.6)°. The degree of reduction was better than that of CREF Group [(1.2±1.3mm), (8.0±1.5)°](P<0.05). The mobility of patients recovered well in one year after operation, and the flexion and back extension of ORIF group were better than those in CREF group (P<0.05). There were no significant difference in the incidence of complications between the two groups and garland werley function score in 1 year after operation (P>0.05).

Conclusion

The combined volar dorsal approach with bone graft plate internal fixation and external fixation have good results in the treatment of AO C type elderly distal radius fractures, but in the aspect of postoperative wrist movement, the combined volar dorsal approach with bone graft plate internal fixation has more advantages.

Key words: Radius fractures, Aged, External fixation, Fracture fixation, internal

Bingji Lin, Peiyi Guo, Zihong Zhang, Senmiao Ke, Yang Wang. Clinical study on the combined volar dorsal approach with bone graft and plate internal fixation for the treatment of elderly type C distal radius fractures[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(05): 284-290.

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Figures/Tables 6

References 27

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组别	例数	年龄（岁，±s）	性别（例，男/女）	骨折分型（例）			合并糖尿病（例，有/无）	克氏辅助（例，有/无）	术前住院天数（d，±s）	BMI指数(kg/m²)
组别	例数	年龄（岁，±s）	性别（例，男/女）	C1	C2	C3	合并糖尿病（例，有/无）	克氏辅助（例，有/无）	术前住院天数（d，±s）	BMI指数(kg/m²)
CREF组	45	65±5	21/24	20	16	9	24/21	10/35	1.2±0.5	23.8±2.4
ORIF组	40	65±5	18/22	18	15	7	22/18	15/25	1.5±0.4	23.6±2.6
统计值		t=0.731	χ²=0.024	χ²=0.094			χ²=0.024	χ²=2.387	t=1.856	t=0.635
P值		0.482	0.878	0.954			0.878	0.122	0.084	0.546

组别	例数	年龄（岁，±s）	性别（例，男/女）	骨折分型（例）			合并糖尿病（例，有/无）	克氏辅助（例，有/无）	术前住院天数（d，±s）	BMI指数(kg/m²)
组别	例数	年龄（岁，±s）	性别（例，男/女）	C1	C2	C3	合并糖尿病（例，有/无）	克氏辅助（例，有/无）	术前住院天数（d，±s）	BMI指数(kg/m²)
CREF组	45	65±5	21/24	20	16	9	24/21	10/35	1.2±0.5	23.8±2.4
ORIF组	40	65±5	18/22	18	15	7	22/18	15/25	1.5±0.4	23.6±2.6
统计值		t=0.731	χ²=0.024	χ²=0.094			χ²=0.024	χ²=2.387	t=1.856	t=0.635
P值		0.482	0.878	0.954			0.878	0.122	0.084	0.546

组别	例数	手术时间（min，±s）	骨折愈合时间（w，±s）	住院天数（d，±s）
CREF组	45	41±10	9.2±2.7	4.1±1.0
ORIF组	40	72±9	12.0±2.5	7.4±1.2
t值		15.21	4.235	8.453
P值		0.001	0.001	0.001

组别	例数	手术时间（min，±s）	骨折愈合时间（w，±s）	住院天数（d，±s）
CREF组	45	41±10	9.2±2.7	4.1±1.0
ORIF组	40	72±9	12.0±2.5	7.4±1.2
t值		15.21	4.235	8.453
P值		0.001	0.001	0.001

组别	例数	掌倾角（°）	尺偏角（°）	关节塌陷（mm）	桡骨高度（mm）
CREF组	45	8.0±1.5	20.2±2.1	1.2±1.3	11.4±2.1
ORIF组	40	10.5±1.6	20.3±2.2	0.7±1.3	11.2±2.0
t值		3.834	0.121	5.857	0.574
P值		<0.001	0.909	<0.001	0.568

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