Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang 325000, China.
Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, Zhejiang 325000, China.
Injury. 2021 Oct;52(10):2947-2951. doi: 10.1016/j.injury.2021.07.041. Epub 2021 Jul 31.
The purpose of our study was to determine the risk factors for reduction loss in patients with proximal humeral fractures after locking plate fixation and establish a nomogram prediction model.
We retrospectively analyzed the clinical data of proximal humeral fractures patients who had been surgically treated for locking plate in our institution from January 2016 to December 2018. Perioperative information was obtained through the electronic medial record system, univariate and multivariate analyzes were performed to determine the risk factors of reduction loss, and a nomogram model was constructed to predict the risk of reduction loss. The predictive performance and consistency of the model were evaluated by the consistency coefficient (C-index) and the calibration curve, respectively.
115 patients were finally enrolled in our study. Multivariate analysis results showed that age, fracture classification, medial comminution, and calcar screw status were independent risk factors for reduction loss. The accuracy of the contour map for predicting transfusion risk was 0.944.
We found a correlation between reduction loss and age, fracture classification, medial comminution, and calcar screw status after locking plate fixation for proximal humeral fractures patients. Our nomogram is helpful for clinicians to identify high-risk patients, early intervention and reduce the incidence of reduction loss.
本研究旨在确定锁定钢板固定治疗肱骨近端骨折患者复位丢失的风险因素，并建立列线图预测模型。
我们回顾性分析了 2016 年 1 月至 2018 年 12 月在我院接受锁定钢板手术治疗的肱骨近端骨折患者的临床资料。通过电子病历系统获取围手术期信息，采用单因素和多因素分析确定复位丢失的风险因素，并构建列线图模型预测复位丢失的风险。通过一致性系数（C 指数）和校准曲线分别评估模型的预测性能和一致性。
最终纳入 115 例患者。多因素分析结果表明，年龄、骨折分型、内侧粉碎、及距骨螺钉状态是复位丢失的独立危险因素。预测输血风险的轮廓图的准确性为 0.944。
我们发现锁定钢板固定治疗肱骨近端骨折患者复位丢失与年龄、骨折分型、内侧粉碎、及距骨螺钉状态有关。我们的列线图有助于临床医生识别高危患者，早期干预，降低复位丢失的发生率。
