Risk of re-displacement after external fixation treatment for distal radius fractures in older adult patients and development of a momogram model
10.3760/cma.j.cn341190-20240124-00107
- VernacularTitle:外固定治疗老年人桡骨远端骨折术后发生再移位风险及列线图模型的建立
- Author:
Zuoxi CHEN
1
;
Qingliu ZHOU
;
Zhengliang HUANG
;
Qiang ZHOU
Author Information
1. 温州市中西医结合医院创伤骨科，温州 325000
- Publication Type:Journal Article
- Keywords:
Radius fractures;
Wrist joint;
Factor analysis, statistical;
Logistic models;
Nomograms
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(6):865-869
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk of re-displacement after external fixation treatment for distal radius fractures in older adult patients and establish a nomogram model.Methods:A retrospective analysis was conducted on the clinical data of 96 older adult patients with distal radius fractures who were treated with external fixation at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January to December 2022. Based on whether re-displacement of the fracture occurred, the patients were divided into an observation group (re-displacement occurred, n = 15) and a control group (no re-displacement occurred, n = 81). Univariate and logistic regression analyses were used to identify risk factors, and a nomogram model was established. Results:There were statistically significant differences between the two groups in terms of age ( t = 2.13, P = 0.036), sex ( χ2 = 4.17, P = 0.041), presence of comminution ( χ2 = 14.18, P < 0.001), fracture type ( χ2 = 49.59, P < 0.001), body mass index ( t = 3.01, P = 0.003), number of adjustments to external fixation ( χ2 = 4.17, P = 0.041), presence of bone resorption or necrosis ( χ2 = 13.96, P < 0.001), appropriateness of external fixation management ( χ2 = 21.43, P < 0.001), and reasonableness of functional exercise ( χ2 =23.67, P < 0.001). Independent risk factors for the occurrence of re-displacement after external fixation treatment for distal radius fractures in older adult patients included age ( OR = 3.07, P = 0.002), sex ( OR = 3.11, P = 0.007), presence of comminution ( OR = 2.56, P = 0.039), presence of bone resorption or necrosis ( OR = 5.70, P < 0.001), and reasonableness of functional exercise ( OR = 3.04, P < 0.001). The discrimination analysis of the nomogram model showed an area under the curve of 0.855, with a 95% CI of 0.853 to 0.927, and a critical value of 31.25% ( P < 0.001). The GiViTI calibration curve showed that the 80%-90% confidence intervals did not cross the 45° bisector in the graph ( P > 0.05). The Hosmer-Lemeshow goodness-of-fit test showed no statistically significant difference ( χ2 = 5.29, P = 0.582). The decision curve analysis indicated that when the risk of re-displacement exceeded 33.64% in older adult patients undergoing external fixation for distal radius fractures, the net benefit of intervening in these patients was maximized. Conclusions:Age, sex, presence of comminution, presence of bone resorption or necrosis, and the reasonableness of functional exercise are independent risk factors for re-displacement after external fixation treatment of distal radius fractures in older adult patients. The higher the score on the nomogram model, the greater the risk of fracture re-displacement in the patient.
