Prediction Of The Displacement Of Distal Radius Fracture At The Early Stage Of Conservative Treatment In Patients Older Than 65 Years

Objective If the displacement of conservatively treated distal radius fractures(DRF)is predicted at the early stage of treatment in elderly patients,the expected degree of displacement after complete healing when cast treatment is used will also be clear,and thus,lead to appropriate management of such cases.The primary aim of this study was to explore whether the final displacement of conservatively treated DRF can be predicted at the early stage of treatment in patients aged 65 years and older.The secondary aim was to analyze the radiographic outcomes following conservative treatment of DRF at the time of injury,after reduction,at 1-3 weeks,and after bony consolidation.Methods This retrospective study included 101 patients.The outcome measures consisted of the dorsal angulation(DA),radial angle(RA),and radial length(RL)at each time point.The fractures were classified according to the Orthopaedic Trauma Association system.Linear regression was used to analyze the radiological measurements at different time points.In addition,the imaging results of all patients after healing were divided into "acceptable group" and "unacceptable group" by Lidstrom classification.Taking Lidstrom classification after healing as the gold standard,ROC curve was used to test the prediction effect of the obtained linear regression function on the degree of bone deformity after healing.Results DA,RA,and RL between the time point of “injury”,“after reduction”,“at 1-3 weeks” and “complete healing” all were correlated.Additionally,the strongest correlations were observed for the DA,RA,and RL between the time points of “about 1-3 weeks” and “complete healing”(r=0.89,r=0.79,and r=0.88,respectively).ROC curve showed that the linear regression function obtained had high prediction specificity and sensitivity,and the prediction efficiency of each imaging parameter in 1-3 weeks was the strongest(AUC of DA1-3weeks : 0.634 ? RL1-3weeks :0.924?RA1-3weeks:0.854).Conclusion The DA,RA,and RL after complete healing can be predicted by linear regression functions at the early stage of treatment in elderly patients.If the predicted DA,RA,and RL at the time of “complete healing” do not meet the acceptable criteria,reduction could be performed again or surgical treatment could be chosen immediately.