Comparison of the effects of external fixator and open reduction and internal fixation in the treatment of unstable distal radius fractures and its influence on pain score / 中国基层医药

ABSTRACT

Objective To compare the effects of external fixator and open reduction and internal fixation on unstable distal radius fractures and the influence on pain score.Methods From March 2012 to March 2016, 100 cases of unstable distal radius fractures admitted in Pinggu Hospital Affiliated to Capital Medical University were selected in this research.According to different treatment ,the patients were divided into external fixed group (n＝50) and internal fixation group (n＝50).The external fixation group was treated with external fixator,and the internal fixation group was treated by open reduction and plate fixation.The clinical efficacy of the two groups and their effect on pain score were compared.Results At 3 months,12 months after operation,the articular surface steps in the internal fixa-tion group were (2.35 ±0.42)mm and (0.93 ±0.46)mm,respectively,which were significantly lower than those of the external fixation group [(2.99 ±0.38)mm,(1.41 ±0.57)mm],and the differences were statistically significant (t＝7.990,4.634,P＝0.000,0.000).The palmar inclination in the internal fixation group were (12.66 ±1.40)° and (13.32 ±1.74)°,respectively,which were significantly higher than those of the external fixation group [(9.66 ± 1.87)°,(11.35 ±1.94)°],and the differences were statistically significant (t＝9.081,5.345,P＝0.000,0.000). The ulnar deviation angle in the internal fixation group were (23.89 ±1.67)°and (24.81 ±2.02)°,respectively, which were significantly higher than those of the external fixation group [(21.59 ±1.94)°,(22.91 ±2.32)°],and the differences were statistically significant (t＝6.353,4.367,P＝0.000,0.000).The radial height in the internal fixation group were (10.23 ±0.38)mm,(11.45 ±0.42)mm,respectively,which were significantly higher than those of the external fixation group [(9.77 ±0.36)mm,(10.89 ±0.43)mm],and the differences were statistically significant (t＝6.214,6.588,P＝0.000,0.000).The excellent and good rate of wrist function recovery in the internal fixation group and the external fixation group was 82%and 74%,respectively.There was no statistically significant difference between the two groups (χ2＝0.932,P＝0.334).At 1 day,3 days after operation,the VAS scores of the external fixation group were (4.35 ±0.35)points and (2.10 ±0.46)points,respectively,which were lower than those of the internal fixation group [(5.46 ±0.71)points,(3.12 ±0.56)points],the differences between the two groups were statistically significant (t＝9.860,9.952,P＝0.000,0.000).No fracture nonunion occurred in the two groups.The clinical healing time of the external fixation group was (9.10 ±1.13) weeks,which was significantly shorter than that of the internal fixation group [(10.85 ±1.77) weeks],and there was statistically significant difference between the two groups (t＝5.893,P＝0.000).Conclusion The reduction effect of open reduction and plate fixation is better than external fixator,external fixator can effectively relieve postoperative pain and accelerate fracture healing .It is suggested that individualized treatment should be selected according to the fracture type and specific circumstances .