Abstract：
The relationship between volar fragment size and postoperative volar tilt loss in complete articular distal radius fracture is not well known. In this study, we measured precise radiological parameters to help identify other factors that might contribute to volar tilt loss.
We retrospectively reviewed the radiological examinations and charts of 256 patients with distal radial fracture who underwent volar locking plate fixation between March 2014 and July 2022. Radiological parameters were measured based on preoperative CT and immediate postoperative radiographs. Univariate and multivariate linear regression analysis was performed to identify relevant factors associated with volar tilt loss following volar locking plate fixation. The receiver operating characteristic curve was used to identify the cutoff value of the independent parameters.
On univariate analysis, 2 radiologic parameters on preoperative CT (volar fragment length at the lunate fossa, and teardrop angle) and 4 on immediate postoperative X-ray (radial inclination, radial length, capitate shift, and volar tilt) were significantly associated with postoperative volar tilt loss. On multivariate linear regression analysis, the risk of volar tilt loss increased as the capitate moved toward the back of the radial shaft. The cut-off for anteroposterior length in the lunate fossa was 6.5 mm.
AO/OTA type-C distal radius fractures with <6.5 mm anteroposterior length in the lunate fossa had significantly higher rates of malunion with dorsal deformity. In addition, preoperative teardrop angle <37.2 ° and immediate postoperative volar tilt <3.7º are also predictors of postoperative volar tilt loss.
We retrospectively reviewed the radiological examinations and charts of 256 patients with distal radial fracture who underwent volar locking plate fixation between March 2014 and July 2022. Radiological parameters were measured based on preoperative CT and immediate postoperative radiographs. Univariate and multivariate linear regression analysis was performed to identify relevant factors associated with volar tilt loss following volar locking plate fixation. The receiver operating characteristic curve was used to identify the cutoff value of the independent parameters.
On univariate analysis, 2 radiologic parameters on preoperative CT (volar fragment length at the lunate fossa, and teardrop angle) and 4 on immediate postoperative X-ray (radial inclination, radial length, capitate shift, and volar tilt) were significantly associated with postoperative volar tilt loss. On multivariate linear regression analysis, the risk of volar tilt loss increased as the capitate moved toward the back of the radial shaft. The cut-off for anteroposterior length in the lunate fossa was 6.5 mm.
AO/OTA type-C distal radius fractures with <6.5 mm anteroposterior length in the lunate fossa had significantly higher rates of malunion with dorsal deformity. In addition, preoperative teardrop angle <37.2 ° and immediate postoperative volar tilt <3.7º are also predictors of postoperative volar tilt loss.
摘要：
目的：掌侧碎片大小与完全性桡骨远端关节骨折术后掌侧倾斜丢失之间的关系尚不清楚。在这项研究中,我们测量了精确的放射学参数，以帮助确定可能导致掌侧倾斜损失的其他因素。
方法：我们回顾性回顾了2014年3月至2022年7月接受掌侧锁定钢板内固定术的256例桡骨远端骨折患者的影像学检查和图表。根据术前CT和术后即刻X光片测量放射学参数。进行了单因素和多元线性回归分析，以确定掌侧锁定钢板固定后与掌侧倾斜损失相关的相关因素。接收器工作特性曲线用于确定独立参数的截止值。
结果：关于单变量分析，术前CT的2个放射学参数（月窝的掌侧碎片长度，和泪滴角)和4在术后即刻X射线(径向倾斜，径向长度,大写移位，和掌侧倾斜）与术后掌侧倾斜损失显着相关。在多元线性回归分析中，随着头端向径向轴的后部移动，掌侧倾斜损失的风险增加。月窝前后长度的截止值为6.5mm。
结论：月窝前后长度<6.5mm的AO/OTA-C型桡骨远端骨折伴背侧畸形的畸形愈合率明显较高。此外,术前泪滴角<37.2°和术后即刻掌侧倾斜<3.7º也是术后掌侧倾斜丢失的预测因子。
方法：我们回顾性回顾了2014年3月至2022年7月接受掌侧锁定钢板内固定术的256例桡骨远端骨折患者的影像学检查和图表。根据术前CT和术后即刻X光片测量放射学参数。进行了单因素和多元线性回归分析，以确定掌侧锁定钢板固定后与掌侧倾斜损失相关的相关因素。接收器工作特性曲线用于确定独立参数的截止值。
结果：关于单变量分析，术前CT的2个放射学参数（月窝的掌侧碎片长度，和泪滴角)和4在术后即刻X射线(径向倾斜，径向长度,大写移位，和掌侧倾斜）与术后掌侧倾斜损失显着相关。在多元线性回归分析中，随着头端向径向轴的后部移动，掌侧倾斜损失的风险增加。月窝前后长度的截止值为6.5mm。
结论：月窝前后长度<6.5mm的AO/OTA-C型桡骨远端骨折伴背侧畸形的畸形愈合率明显较高。此外,术前泪滴角<37.2°和术后即刻掌侧倾斜<3.7º也是术后掌侧倾斜丢失的预测因子。
