Analysis of influencing factors of wrist dorsal extension angle and function after radius distal fracture surgery

Abstract

Objective To explore the influencing factors of wrist dorsal extension angle and wrist function recovery after distal radius fractures. Methods From July 2012 to January 2016, 116 patients with distal radius fractures were treated with palmar plate internal fixation. Follow-up included wrist range of motion, X-ray, measurement of imaging parameters, complications, grip strength, pinch strength, PRWE and DASH scores. According to the recovery of dorsal extension angle and Gartland-Werley scoring criteria, patients with dorsal extension angle less than 45° were classified as groupⅠ (functional restricted group), and patients with dorsal extension angle more than 45° were classified as group Ⅱ (functional unrestricted group). Then, the differences of age, injury side, fracture type, imaging parameters, ulnar styloid process fracture and complications between the two groups were compared, and whether these factors were the influencing factors of different dorsal extension angles were judged. The effects of these factors on wrist PRWE and DASH scores were analyzed. Results There were no significant differences in age, injured side, fracture type, imaging parameters and whether there were fractures of ulnar styloid process between the two groups (P>0.05). There were significant differences in wrist flexion angle, ulnar deviation angle, pronation angle and grip strength between the two groups. The parameters of groupⅠwere lower than those of groupⅡ(P<0.05). The survival analysis of influencing factors of wrist dorsal extension recovery showed that the recovery of ulnar inclination and palmar inclination had an effect on wrist dorsal extension by univariate analysis, while age had an effect on wrist dorsal extension by multivariate analysis; age and ulnar variation had an effect on PRWE score by univariate analysis, and gender and ulnar variation had an effect on PRWE score by multivariate analysis; age had an impact on DASH score by univariate analysis, and gender had an impact on DASH score by multivariate analysis. Conclusion Patients' age, ulnar inclination and palmar inclination are important factors affecting wrist dorsal extension, while age, gender and ulnar variation affect PRWE and DASH scores in varying degrees. Key words: Radius fractures; Wrist joint; Dorsal extension; Influencing factors