Closed reduction and external fixation for treatment of AO type C distal radius fractures in the elderly:biological advantage / 中国组织工程研究

ABSTRACT

BACKGROUND:Unstable distal radius fracture is the most common fracture in the elderly patients, how to treat this kind of intra-articular distal radius fracture remains controversial. OBJECTIVE:To summarize the clinical, radiographic outcomes and complications of closed reduction and external fixation of the AO type C distal radial fracture. METHODS:From May 2009 to May 2012, we performed closed reduction and external fixation in 122 patients (122 wrists) with the AO type C distal radial fractures. According to AO fracture classificationC1 in 16 patients, C2 in 63 patients, and C3 in 43 patients. The study participants underwent clinical and radiographical evaluation at 3, 6, 12 weeks, and 1 year postoperatively and annual y thereafter. Wrist joint function of patients was anteroposterior and lateral X-ray films by palmar angulation, ulnar variance, radial height, and quality of articular reduction according to Knirck’s classification. RESULTS AND CONCLUSION:Al 122 patients were fol owed up for 13 to 28 months. The mean operative time was 19.1±11.2 minutes;the mean fluoroscopy time was 7.8±2.6 seconds;the mean bleeding loss was 45.7±14.8 mL;the mean length of hospital stay was 2.7±1.9 days;the mean union time was 3.1±0.7 months. At the final fol ow-up, the average modified McBride score was 6.7 points (range, 1 to 23 points), the rate of good to excel ent was 62%. The average palmar angulation was 11.7±2.6° (range, 10° to 15°). The average ulnar variance was 21.3±5.7° (range, 18° to 26°). The mean radial height was 12.9±2.8 mm (range, 10 to 16 mm). Quality of articular reduction based on Knirck and Jupiter’s classification shows Stage 1 in 108 patients and Stage 2 in 14 patients. Eight patients (6.6%) suffered from postoperative complications, including pin tract infection in six patients, sensory branch of the radial nerve neuritis in two patients. Results verified that closed reduction and external fixation of the AO type C distal radial fractures can achieve a satisfactory clinical function, has a less trauma, shorter hospital stay, lower rate of complications, faster fracture union, especial y is suitable for treatment of the AO type C distal radial fractures in the elderly.