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.%目的 比较保守治疗手法复位夹板外固定与手术切开复位掌侧钢板内固定治疗老年C3型桡骨远端骨折的临床效果.方法 回顾性分析2009年7月～2016年12月在恩施州民族医院住院的97例65岁以上C3型桡骨远端骨折患者的临床资料.根据治疗方法不同分为保守组(55例)和手术组(42例).保守组采用手法复位夹板外固定治疗,手术组采用切开复位掌侧钢板内固定.比较两组住院时间和住院费用、术后并发症、术后复位情况、术后功能恢复情况及患者对治疗的满意度.结果 保守组住院费用及住院时间低于手术组,差异有统计意义(P＜0.05);保守组并发症发生率(1.82％)低于手术组(7.14％),但差异无统计意义(P＞0.05).术后1d及1周Lidstrom评分优良率比较,差异无统计学意义(P＞0.05);而术后1个月及术后6个月保守组优良率低于手术组,差异均有统计意义(P＜0.05).保守组腕关节Dienst功能评价优良率为74.55％,手术组为88.10％,差异无统计意义(P＞0.05).保守组患者满意度(89.10％)高于手术组(71.43％),差异有统计意义(P＜0.05).结论 对无法耐受手术、治疗要求不高或不同意行手术的老年桡骨远端骨折患者,手法复位夹板外固定为最佳的治疗方式.
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