Department of Microrepair and Reconstruction, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
BMC Surg. 2021 Jan 6;21(1):11. doi: 10.1186/s12893-020-01033-x.
Common peroneal nerve (CPN) injury is one of the most common nerve injuries in the lower extremities and the motor functional recovery of injured common peroneal nerve (CPN) was often unsatisfactory, the mechanism of which is still controversial. The purpose of this retrospective study was to determine the prognostic factors in patients who underwent surgery for CPN injury and provide a tool for clinicians to assess the patients' prognosis.
This is a retrospective cohort study of all patients who underwent neural exploration for injured CPN from 2009 to 2019. A total of 387 patients with postoperative follow-up more than 12 months were included in the final analysis. We used univariate logistics regression analyses to explore explanatory variables which were associated with recovery of neurological function. By applying multivariable logistic regression analysis, we determined variables incorporated into clinical prediction model, developed a nomogram by the selected variables, and then assessed discrimination of the model by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
The case group included 67 patients and the control group 320 patients. Multivariate logistic regression analysis showed that area (urban vs rural, OR = 3.35), occupation("blue trouser" worker vs "white-trouser" worker, OR = 4.39), diabetes (OR = 11.68), cardiovascular disease (OR = 51.35), knee joint dislocation (OR = 14.91), proximal fibula fracture (OR = 3.32), tibial plateau fracture (OR = 9.21), vascular injury (OR = 5.37) and hip arthroplasty (OR = 75.96) injury increased the risk of poor motor functional recovery of injured CPN, while high preoperative muscle strength (OR = 0.18) and postoperative knee joint immobilization (OR = 0.11) decreased this risk of injured CPN. AUC of the nomogram was 0.904 and 95% CI was 0.863-0.946.
Area, occupation, diabetes, cardiovascular disease, knee joint dislocation, proximal fibula fracture, tibial plateau fracture, vascular injury and hip arthroplasty injury are independent risk factors of motor functional recovery of injured CPN, while high preoperative muscle strength and postoperative knee joint immobilization are protective factors of motor functional recovery of injured CPN. The prediction nomogram can provide a tool for clinicians to assess the prognosis of injured CPN.
腓总神经（CPN）损伤是下肢最常见的神经损伤之一，受伤腓总神经（CPN）的运动功能恢复往往不尽如人意，其机制仍存在争议。本回顾性研究的目的是确定接受 CPN 损伤手术治疗的患者的预后因素，并为临床医生提供评估患者预后的工具。
这是一项对 2009 年至 2019 年间接受神经探查治疗 CPN 损伤的所有患者进行的回顾性队列研究。共有 387 例术后随访超过 12 个月的患者被纳入最终分析。我们使用单变量逻辑回归分析来探讨与神经功能恢复相关的解释变量。通过多变量逻辑回归分析，我们确定了纳入临床预测模型的变量，通过选定变量开发了一个列线图，并通过接收者操作特征（ROC）曲线下的曲线面积（AUC）评估模型的区分度。
病例组包括 67 例患者，对照组包括 320 例患者。多变量逻辑回归分析显示，受伤 CPN 运动功能恢复不良的独立危险因素包括居住地（城区 vs 农村，OR=3.35）、职业（“蓝领”工人 vs “白领”工人，OR=4.39）、糖尿病（OR=11.68）、心血管疾病（OR=51.35）、膝关节脱位（OR=14.91）、腓骨近端骨折（OR=3.32）、胫骨平台骨折（OR=9.21）、血管损伤（OR=5.37）和髋关节置换术（OR=75.96）。而术前肌肉力量高（OR=0.18）和术后膝关节固定（OR=0.11）降低了受伤 CPN 运动功能恢复不良的风险。列线图的 AUC 为 0.904，95%CI 为 0.863-0.946。
居住地、职业、糖尿病、心血管疾病、膝关节脱位、腓骨近端骨折、胫骨平台骨折、血管损伤和髋关节置换术是受伤 CPN 运动功能恢复的独立危险因素，而术前肌肉力量高和术后膝关节固定是受伤 CPN 运动功能恢复的保护因素。预测列线图可为临床医生评估受伤 CPN 的预后提供工具。
