Orthopaedic Surgery (Jan 2024)
Factors Associated with Re‐Displacement after Nonsurgical Treatment of Distal Radius Fractures in Adults: A Retrospective Study
Abstract
Objective Closed reduction combined with external fixation is a frequently utilized approach for treating distal radial fractures in adults. Nonetheless, the potential for re‐displacement following external fixation remains. Analyzing the factors influencing re‐displacement after nonsurgical treatment of distal radial fractures in adults is vital for preventing re‐displacement and making prognostic assessments. Methods A retrospective analysis was performed on 884 patients who underwent nonsurgical treatment for distal radius fractures in the reduction room of the Orthopedics and Traumatology Department of Integrated Traditional Chinese and Western Medicine at Tianjin Hospital, Tianjin, China, between July 2019 and December 2022. Patients were categorized into two groups, namely displaced and nondisplaced, based on radiographic outcomes. Factors affecting fracture re‐displacement were examined, including sex, age, side, AO/OTA type, external fixation, and radiographic outcomes at pre‐reduction and immediate reduction. Logistic regression analysis was employed to identify the risk factors for fracture re‐displacement, and ROC curves were constructed. Results Among the 884 patients, 563 (63.69%) experienced re‐displacement after fracture reduction. There were no statistically significant differences (p > 0.05) between the two groups in terms of gender, external fixation method, and palmar tilt angle at pre‐reduction and immediate reduction, while significant differences (p 3.26 mm at pre‐reduction, and ulnar variance >2.055 mm at immediate reduction were high‐risk factors for fracture re‐displacement. Conclusions Nonsurgical treatment of distal radius fractures exhibits a higher rate of re‐displacement. Age, AO/OTA type, pre‐reduction, and immediate reduction ulnar variance are key factors predicting fracture re‐displacement.
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