| ObjectiveWe retrospectively analyzed the imaging parameters and wrist Cooney scores of 100 elderly Colles fracture patients to evaluate the clinical significance of imaging parameters of elderly Colles fracture on the recovery of wrist function,hoping to provide more references for optimizing the clinical treatment of elderly Colles fracture and improving the quality of wrist function recovery.MethodsAccording to the strict inclusion criteria,100 elderly patients with Colles’ fracture were selected from the outpatients of the Department of Orthopaedics,Foshan Hospital of Traditional Chinese Medicine from 02/2020 to 02/2021 who underwent the "Fourteen Methods of Orthopaedic Bone Setting" combined with small splint external fixation,and the standard positive and lateral wrist X-rays taken before,after,1-2 weeks,and 4-6 weeks after the repositioning were collected.The Cooney wrist score results were collected at one follow-up visit between 12 and 24 months after the first visit,and the data were verified and then analyzed statistically using SPSS 25.0 statistical software.Multiple non-linear regression analysis was performed to correlate the Cooney wrist score results with palmar inclination angle,ulnar deviation angle,and radial height.Results1.Based on the inclusion and exclusion criteria,a total of 100 cases eligible for the subject were selected,and a total of 12 cases were disenrolled during the follow-up period,representing a 12% disenrollment rate.Finally,88 patients participated in the whole study,including 72 female patients,accounting for 81.8% of the total study cases,and 16 male patients,accounting for 18.2% of the total study cases.The age of the cases participating in the study ranged from 60-78 years and the age distribution of the patients was characterised by quartiles(63.0,67.5,71.0).2.The Cooney scores obtained at follow-up ranged from 72-98 and the distribution of Cooney scores in quartiles was characterized as(90.0,90.5,91.0).69 cases(78.4% of the total number of cases)scored 90-100,15 cases(17.0% of the total number of cases)scored80-89,4 cases(4.5% of the total number of cases)scored 65-79 and 0 cases(0% of the total number of cases)scored <65.The number of cases with a score of 65-79 was 4.5%,0 cases with a score of <65,accounting for 0% of the total number of cases,and 84 cases with a score of 80 or above,representing an excellent rate of 95.5%.3.The range of palmar inclination measured on standard lateral wrist radiographs taken prior to resetting was-17.19° to 4.96°,with a mean value of-6.91° ± 0.58°,the range of ulnar deviation was 10.14° to 19.21°,with a mean value of 14.37° ± 0.25°,and the range of radial height was The range of palmar inclination measured on the standard lateral wrist radiographs taken immediately after repositioning was 3.39°-15.73°,with a mean value of9.71°±0.29°,and the range of ulnar deviation was 15.23°-23.68 The range of palmar declination angle measured on standard lateral wrist radiographs taken 1-2 weeks after repositioning was 2.08°-15.02°,with a mean value of 9.71°±0.29°,the range of ulnar declination angle was 15.23°-23.68°,with a mean value of 19.24°±0.21°,and the range of radial height was 8.24mm-12.02 mm,with a mean value of 10.27mm±0.94 mm.The range of the palmar inclination angle measured on the standard lateral wrist radiographs taken 1-2weeks after restoration was 2.08°-15.12°,with a mean value of 8.77°±0.35°,the range of the ulnar deviation angle was 14.99°-23.03°,with a mean value of 18.76°±0.21°,and the range of the radial height was 8.18mm-12.01 mm,with a mean value of The range of palmar inclination measured on standard lateral and frontal wrist films taken 4-6 weeks after restoration was 2.16°-15.05°,with a mean value of 8.77°±0.35°,and the range of ulnar deviation was 14.97°-23.01 ° with a mean value of 18.75°±0.21°,and radial height ranged from 8.16mm-12.01 mm with a mean value of 10.19mm±0.10 mm.4.The differences between the mean values of palmar tilt,ulnar deviation and radial height before and immediately after resetting,immediately after resetting and 1-2 weeks after resetting,and immediately after resetting and 4-6 weeks after resetting were statistically significant(p<0.01).The comparison of the mean values of palmar inclination,ulnar deviation and radial height at 1-2 weeks after repositioning with those at 4-6 weeks after repositioning was not statistically significant(P > 0.05).The correlation between the palmar inclination,ulnar deviation and radial height at 4-6 weeks after repositioning and Cooney’s score was performed.A multivariate non-linear regression analysis of the palmar inclination angle,ulnar deviation angle,radial height and Cooney’s score was performed4-6 weeks after repositioning,and the regression equation was obtained as:Y=0.2766X1+0.0831X2+0.9271X3+76.13.Conclusion1.The Fourteen Bone-setting manipulation can effectively improve the imaging parameters related to Colles fractures in the elderly to varying degrees.2.The excellent rate of the Fourteen Bone-setting manipulation Combined with Small Splint in the treatment of Colles fractures in the elderly is as high as 95.5%,which indicates that the orthopaedic method is effective in the treatment of Colles fractures in the elderly and is worthy of massive clinical application.3.The dynamic splint fixation of Foshan Hospital of Traditional Chinese Medicine can effectively prevent or reduce the re-displacement after resetting.4.The radial height is most related to the recovery of wrist joint function,so the clinicians should pay special attention to the recovery of radial height.5.After the clinical bony healing,when the radial height reaches above 8.66 mm,the palmar inclination angle reaches above 3.62°,and the ulnar deviation angle reaches above15.84°,the wrist joint function can achieve excellent recovery. |
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