Analyze the related factors of early wrist joint function recovery after small splint treatment for elderly distal radius fractures.

A retrospective analysis was conducted on the clinical data of 515 elderly patients with distal radius fractures treated with mini splints at Tangshan Second Hospital in Hebei Province from January 2020 to January 2023. There were 286 males and 229 females with an average age of (75.82±7.64) years. According to the recovery of wrist joint, the patients were divided into good recovery group (n=350) and poor recovery group (n=165). The general data (age, gender, body mass index, dominant hand, osteoporosis, hypertension, diabetes, hyperlipidemia), clinical data (comminuted fracture, palmar inclination back extension, shortening deformity, fracture type, swelling, stiffness), treatment related indicators (splint fixation time, functional exercise, malunion), wrist joint function evaluation scale (Gartland Werley score, Cooney score) of the two groups were followed up and compared. Multifactor logistic regression was used to analyze the influencing factors of wrist joint function recovery after the treatment of small splint for distal radius fracture in the elderly.

All 515 patients were fully followed up, with a follow-up rate of 100.00% and a follow-up period of 6 to 10 months. The proportion of patients aged ≥75 years and with osteoporosis in the group with poor recovery was significantly higher than that in the group with good recovery (P<0.05). The proportion of patients with comminuted fractures, shortening deformities greater than 5 mm, and fracture types CooneyⅢ-Ⅳ in the group with poor recovery was significantly higher than that in the group with good recovery (P<0.05). The proportion of patients in the poor recovery group who had a fixation time of 5 weeks, no functional exercise, and abnormal healing was significantly higher than that in the good recovery group (P<0.05). The Gartland Welley score (12.36±2.07 points) of patients with poor recovery was significantly higher than that of patients with good recovery (4.52±1.39 points), and the Cooney score (78.72±4.16 points) was significantly lower than that of patients with good recovery (90.26±3.45 points) (t=50.673, 33.100, P<0.05). The factors with statistically significant differences in univariate analysis were assigned values, and multivariate logistic regression analysis showed that age ≥ 75 years (OR=7.471), osteoporosis (OR=5.853), comminuted fractures (OR=3.785), dwarfism >5 mm (OR=6.841), and fracture type Cooney Ⅲ (OR=3.904). Ⅳ (OR=3.904), 5 weeks of splint fixation time (OR=3.540), no functional exercise (OR=4.845), malunion (OR=6.366), and Gartland Welley score (OR=5.034) are risk factors for poor wrist joint function recovery, The Cooney score (OR=6.354) is a protective factor for poor recovery of wrist joint function (P<0.05).

The probability of poor early recovery of wrist joint function in elderly patients with distal radius fractures treated with small splints is relatively high, accounting for about 32.04%. Among them, age ≥ 75 years, osteoporosis, comminuted fractures, shortening deformities >5 mm, fracture types CooneyⅢand Ⅳ, splint fixation time of 5 weeks, reactive exercise, malunion, Gartland Werley score, Cooney score, etc. are all influencing factors of poor wrist joint function recovery. Clinically, targeted treatment plans can be given according to the patient's situation and characteristics, which can help improve early wrist joint function and help patients recover quickly after surgery.