Objective The type C fracture of distal radius were the common types of fractures,its treatment methods mainly include external fixation and volar locking-plate internal fixation.The choice of operation type is still controversial.This paper will compare the clinical efficacy of the two surgery types,and provide a reference for the clinical application.
Methods A total of 84 cases of type C fracture of distal radius were collected from January,2011 to January,2014 in our hospital.According to the surgery method,42 cases were assigned into external fixation group,another 42 cases into internal fixation group.The operative time,blood loss,hospitalization time,fracture healing time,ulnar deviation,palmar tilt,radial height,and Cooney wrist score at 6 months and 12 months after the operation between the two groups were compared.
Results Compared with internal fixation,the external fixation group was with less operation time (30.2±8.9)min,amount of bleeding during operation (21.7±7.3)ml,hospitalization time (4.3±1.2)d and fracture healing time (11.9±4.4)weeks(
P<0.05),while the external fixation group had great ulnar deviation (20.5±3.1)degree and radial height (13.7±1.8)mm,but the palmar tilt was significantly smaller (10.2±2.9) as compared with the internal fixation group(
P<0.05);6 months after the operation,Cooney wrist score for the range of motion and grip strength score was significantly higher(
P<0.05);the postoperative Cooney wrist score 12 months after the operation for the function,scope of activities,flexion/extension activity and grip strength were significantly higher(
P<0.05);One years after the operation,the excellent and good rate of external fixation group was 90.5%,and of the internal fixation group was 81.0%,the differences between the two groups was significant(
P<0.05).
Conclusion Volar locking-plate internal fixation and external fixator for type C distal fractures of distal radius can achieve good effect.The external fixator is with advantages of quick recover after operation,small trauma,good wrist joint activities and higher excellent rate.