Investigation of fracture healing time distribution and delayed healing factors after volar plate open reduction and internal fixation for distal radius fractures
Objective To explore the factors influencing the fracture healing time distribution and delayed healing after volar plate open reduction and internal fixation for distal radius fractures.Methods A series of 94 patients with distal radius fracture who received treatment in our hospital from June 2019 to April 2022 were selected as research objects and treated with volar plate open reduction and internal fixation.The baseline data of patients were recorded.According to the postoperative healing time of patients with distal radius fracture,all were divided into normal healing group and delayed healing group.LASSO regression analysis was used to screen the factors affecting the postoperative healing time of distal radius fractures.Logistic regression analysis model and decision tree model were used to analyze the factors.The collinearity among multiple factors of Logistic regression model was analyzed using multicollinearity diagnosis,and the analysis results of the two models were compared by receiver operating characteristic(ROC)curve.Construct the line chart model and evaluate its accuracy and clinical practicability.Results Among 94 patients with distal radius fracture,77.66%(73/94)of them healed normally after surgery,with a healing time of(2.6±0.3)months.22.34%(21/94)of them had prolonged postoperative healing time,with healing time of(3.9±0.5)months.Six potential risk factors were identified by LASSO regression analysis:age,fracture type,osteoporosis,severe radius shortening deformity,functional exercise,and iatrogenic soft tissue injury.Logistic regression analysis showed that the age,fracture type,osteoporosis,severely shortened radius deformity and functional exercise were risk factors for prolonged postoperative healing time in patients with distal radius fracture,and the variance inflation factor(VIF)of these factors were all less than 5,and there was no collinearity among all factors.The analysis of decision tree model showed that fracture type,patient age,osteoporosis and functional exercise were influencing factors on postoperative healing time of patients with distal radius fracture.The sensitivity and specificity of Logistic regression analysis model were 79.6%and 82.4%respectively.The sensitivity and specificity of decision tree model were 77.5%and 87.6%respectively.The AUC of Logistic regression analysis model was 0.838(95%CI:0.814-0.883,P<0.001),the AUC of the decision tree model was 0.829(95%CI:0.814-0.883,P<0.001).Both models showed good predictability.The accuracy and clinical practicability of the line chart model were high.Conclusions Patient age,fracture type,osteoporosis,severely shortened radius deformity,and functional exercise are risk factors for postoperative healing time in patients with distal radius fracture treated with volar plate open reduction and internal fixation.
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