[Clinical observation on pulley suspension traction reduction combined with self-made splint fixation for the treatment of extended distal radius fracture].

OBJECTIVE

To explore clinical effects of pulley suspension traction reduction combined with self-made splint fixation in treating extended distal radius fracture.

METHODS

From December 2017 to December 2019, 60 patients with extended distal radius fractures were divided into observation group and control group, 30 patients in each group. In observation group, there were 12 males and 18 females, aged from 50 to 75 years old with an average of (59.63±8.08) years old;according to AO classification, 25 patients were type A2 and 5 patients with type A3;fractures were fixed by pulley suspension traction and self-made splint. In control group, there were 11 males and 19 females, aged from 52 to 76 years old with an average of (59.77±8.03) years old;according to AO classification, 24 patients were with type A2 and 6 patients were type A3;fractures were treated by conventional manipulation with self-made splint fixation. The radius height, ulnar angle and palmar angle between two groups were compared before and after treatment, and clinical effects were evaluated by advanced Green and O'Brien wrist joint scoring after treatment.

RESULTS

All patients were followed up from 11 to 13 months with an average of (11.90± 0.80) months. The splint was removed for 42 to 60 days with an average of (50.20±4.94) days. After removal of splint, X-rays indicated that all patients obtained bone healing with smooth of joint surface. In observation group, radius height was (4.57± 1.16) mm, ulnar angle was (12.83±3.25) °, palmar angle were (-21.17±3.36) ° respectively before treatment, (10.10± 1.75) mm, (24.30±3.16) °, (9.40±2.13) ° respectively at 8 weeks after treatment;in control group, radius height, ulnar angle, palm angle were (4.50±1.43) mm, (12.83±3.10) °, (-21.50±3.38) ° respectively before treatment, and (8.90±1.24) mm, (21.20±2.91) °, (6.16±2.94) ° respectively at 8 weeks after treatment;there were no significant difference in radius height, ulnar deviation angle and palmar inclination between two groups before treatment (>0.05);radius height, ulnar deviation angle and palmar inclination angle of between two groups were significantly improved at 8 weeks after treatment(<0.05), and observation group was significantly better than that of control group (<0.05). Green and O'Brien wrist score of observation group was 90.97±7.92 at follow-up ranged from 11 to 13 months with an average of (11.90±0.80) months, which was significantly higher than that of control group (84.77±9.14) (=2.807, <0.05);in observation group, 18 patients got excellent result, 10 good and 2 fair;in control group, 10 patients got excellent result, 15 good, 3 fair and 2 poor;there was siginifcantly difference between two groups (=-2.15, <0.05).

CONCLUSION

Compared with conventional manual traction and reduction, pulley suspension traction reduction combined with self made splint fixation for the treatment of extended distal radius fracture has more advantages with stable and reliable traction, good reduction, and better wrist joint function. It could be selected and applied according to the actual situation of patients.