Prediction model and validation of nomogram of influence on functional recovery of the wrist joint after fixation of distal radius fracture with external fixation stent combined with Kirschner wire

LIANG Zhong-ming; LI Hai-tao; ZHANG Chuan-yin

doi:10.3969/j.issn.2095-252X.2025.06.006

Abstract：Objective To construct a nomogram prediction model for wrist joint functional recovery after external fixation of distal radius fracture combined with Kirschner wire fixation and to verify its prediction effectiveness.Methods According to the inclusion and exclusion criteria,125 patients with distal radius fractures admitted to the hospital from June 2021 to October 2023 were selected.All of them were treated by external fixation stent combined with Kirschner wire fixation.After the operation,the patients were followed up for 6 months by regular visit to evaluate the recovery of wrist joint function.According to the wrist function recovery at the last follow-up,the enrolled patients were divided into good recovery group and poor recovery group to screen the risk factors affecting the recovery of postoperative wrist joint function and build a nomogram model accordingly.Goodness of fit test and receiver operating characteristic curve(ROC)curve were used to evaluate the predictive efficacy of the model.Results Age≥60 years old(OR=1.782,95%CI:1.607-2.452),osteoporosis(OR=1.805,95%CI:1.624-2.457),comminuted fracture(OR=1.828,95%CI:1.616-2.494),triangular fibrocartilage complex(TFCC)injury(OR=1.845,95%CI:1.602-2.528),palm inclination<10°(OR=1.818,95%CI:1.658-2.474)at the last review,radius contraction≥5 mm at the last review(OR=1.834,95%CI:1.663-2.425)and lack of functional exercise(OR=1.801,95%CI:1.655-2.422)were risk factors for postoperative recovery of wrist function in patients with distal radius fractures.According to this,a nomogram model was constructed,and the results showed that the C-index was 0.882(95%CI:0.725-0.918),the sensitivity and specificity were 91.50%and 80.00%respectively.Conclusions Based on age,osteoporosis,comminuted fracture,TFCC injury,palmar angle at the last review,radius shortening at the last recurrence,and functional exercise after surgery,we predict that patients with distal radius fractures have better functional recovery.