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.

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.

Objective:To explore the mediating effect of psychological adaptation between family empowerment and discharge readiness in premature infants' mothers.Methods:From April 2021 to April 2022, 210 premature infants' mothers from the Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects by the convenience sampling method, and were investigated using Family Empowerment Scale, Psychological Adaptation Scale and Readiness for Hospital Discharge Study-New Mother Form. Pearson correlation analysis was used to analyze the relationship between family empowerment, psychological adaptation and discharge readiness in premature infants' mothers. AMOS 21.0 software was used to establish structural equation model and verify the mediation effect. A total of 210 questionnaires were distributed in this study, and 202 valid questionnaires were recovered, with an effective recovery rate of 96.19% (202/210) .Results:The score of family empowerment in 202 premature infants' mothers was (93.72±12.96) , the score of psychological adaptation was (54.25±9.14) , the score of discharge readiness was (107.36±14.66) . Pearson correlation analysis results showed that family empowerment in premature infants' mothers was positively correlated with psychological adaptation and discharge readiness (r values were 0.473, 0.554, all P<0.01) , and psychological adaptation was positively correlated with discharge readiness ( r=0.584, P<0.01) . The structural equation model results showed that family empowerment of premature infants' mothers could positively predict discharge readiness with an effect value of 0.586, and psychological adaptation had a partial mediating effect between family empowerment and discharge readiness with an effect value of 0.302. Conclusions:Family empowerment can not only positively predict discharge readiness of premature infants' mothers, but also indirectly affect the discharge readiness through psychological adaptation. Nurses staff should improve family empowerment and psychological adaptation of premature infants' mothers, so as to improve discharge readiness.