To develop a nomogram model for predicting the risk of failed manual reduction in patients with distal radius fractures (DRF) and to validate its predictive performance.
Approach:
Key Findings:
Eight independent risk factors were identified: AO classification, severity of swelling, etiology of the fracture, time from injury to reduction, pre-reduction palmar tilt angle, radial shortening height, pre-reduction ulnar deviation angle, and history of alcohol consumption.
The receiver operating characteristic curve showed an area under the curve (AUC) of 0.878 (95% CI: 0.855–0.901), with a sensitivity of 75.4% and a specificity of 82.5%.
The calibration curve demonstrated good agreement between predicted and observed probabilities, with a mean absolute error of 0.005 after bootstrap internal validation (1,000 iterations).
Interpretation:
Limitations:
The study was retrospective and conducted at a single institution.
Osteoporosis was defined based on limited criteria, which may affect classification accuracy.
Researchers urge caution in interpreting joint replacement predictors, noting that surgery reflects access and decision-making as well as disease biology.
