Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (8): 1196-1202.doi: 10.3969/j.issn.2095-4344.1061

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Open reduction and plate fixation versus closed reduction and external fixation for distal radius fractures: scores and linear regression analysis

Ke Wei, Li Ke, Wang Sibo, Du Xinhui, Qiu Zhongpeng, Kang Zhilin, Wang Weishan, Li Gang   

  1. Orthopedics Center, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region, China
  • Online:2019-03-18 Published:2019-03-18
  • Contact: Li Gang, Chief physician, Associate professor, Master’s supervisor, Orthopedics Center, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region, China
  • About author:Ke Wei, Master candidate, Orthopedics Center, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 31760270 (to WSB)

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Abstract:

BACKGROUND: There is no definitive evidence-based medical evidence that volar locking plate fixation is more effective in treating distal radius fractures than other treatments. There is also no evidence that a certain surgical method is the gold standard.

OBJECTIVE: To evaluate the rehabilitation outcomes of plate versus external fixator in the treatment of distal radius fractures.
METHODS: Sixty-four patients with distal radial fractures treated with plate and external fixator from June 2014 to December 2017 were retrospective analyzed. The plate group (n=34) was followed up for (19.15±8.92) months, and the external fixator group (n=30) was followed up for (17.9±11.34) months. The Gartland-Werley score, COONEY score, DASH score, range of motion of the wrist joint, grip strength and distal humeral imaging results were compared. Linear regression analysis was used to analyze the correlation of ulnar variation and humeral height, with forearm pronation and wrist joint deviation.
RESULTS AND CONCLUSION: (1) Sixty-four patients successfully completed the operation and were followed up. At the latest follow-up, in the plate group, Gartland-Werley score: excellent in 21 cases, good in 13 cases. COONEY score: excellent in 20 cases, good in 12 cases, moderate in 2 cases. DASH score was 5.744±4.055. In the external fixator group, Gartland-Werley score: excellent in 24 cases, good in 6 cases. COONEY score: excellent in 24 cases, good in 6 cases. DASH score was 4.872±3.174. There was no significant difference between two groups. (2) Fracture rehabilitation effect: there was no significant difference in palmar flexion, dorsal extension, squatting, supination grip strength ulnar variation, thickness or palm tilt between two groups. The external fixator group had a larger deviation, pre-rotation angle, tibial height and sacral stem tip inclination than the plate group (P=0.000). The radical width in the external fixator group was significantly smaller than that in the plate group (P=0.001). The inclination of the sacral stem tip had an influence on the pre-rotation angle in the external fixator group (P=0.018). The pronation angle became large with the inclination of the sacral stem tip increasing. (3) These results imply that the plate and the external fixator both exhibit good curative efficacy in the treatment of distal radius fracture. The external fixator has the advantages of small incision and no damage to the biological mechanism of the distal radius. 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Radius, Fractures, Bone, External Fixators, Internal Fixators, Tissue Engineering

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