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| Comparative analysis of the clinical effectiveness of conservative treatment and surgery in the treatment of senile type C3 distal radius fracture |
| LUO Yuancheng WANG Jing WANG Kui DIAO Jingming YANG Wei ZHU Bin |
| Department of Tramotology and Orthopedics, the National Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei Province, Enshi 445000, China |
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Abstract Objective To compare the efficacy between manipulative reduction combined with external fixation using the splint and open reduction combined with internal fixation using volar plates in the treatment of senile type C3 distal radius fracture. Methods From July 2009 to December 2016, 97 clinical data of patients with type C3 distal radius fracture aged above 65 years old that received treatments in the National Hospital of Enshi Autonomous Prefecture were analyzed retrospectively and divided into the conservation group (55 cases) and the surgery group (42 cases). The conservation group was treated with manipulative reduction combined with external fixation using the splint and the surgery group was treated with open reduction combined with internal fixation using volar plates. The average hospitalization expenses and average hospitalization time, incidence of complications, postoperative reduction condition, the condition of postoperative functional recovery and the patients′ satisfaction with the treatment were compared between the two groups. Results The hospitalization expenses was less and the hospitalization time was shorter in the conservation group than those of surgery group, with statistically significant differences (P ＜ 0.05). The incidence of complications in the conservation group (1.82%) was lower than that of surgery group (7.14%), but with no statistically significant difference (P ＞ 0.05). There were no statistically significant differences in the excellent rate of 1 d and 1 week Lidstrom scores between the two groups (P ＞ 0.05), but with statistically significant differences in 1 month and 6 month (P ＜ 0.05). The excellent rate of Dienst assessment of wrist joint function in the conservation group was 74.55% and of 88.10% in the surgery group, but with no statistically significant differences (P ＞ 0.05). The patients′ satisfaction in the conservation group(89.10%) was higher than that of surgery group(71.43%), with statistically significant difference(P ＜ 0.05). Conclusion Manipulative reduction combined with external fixation using the splint is the best treatment method for elderly patients who fail to tolerate the surgery, have little requirement for the treatment, or not willing to receive the surgery.
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