Trauma Orthopedics Department, Hanzhong Central Hospital, 723000 Hanzhong, Shaanxi, China.
Ann Ital Chir. 2024;95(4):575-582. doi: 10.62713/aic.3576.
Elbow joint release surgery is commonly used to treat elbow joint stiffness. Though it can restore elbow joint mobility, some patients may still experience range of motion (ROM) loss after surgery. Therefore, this study aims to explore the factors influencing ROM loss after elbow joint release surgery in elderly patients with traumatic elbow stiffness.
This retrospective study included 122 elderly patients with traumatic elbow stiffness who underwent elbow joint release surgery at Hanzhong Central Hospital from January 2023 to April 2024. The patients with range of motion loss were included in the observation group (n = 41), and those without range of motion loss were placed in the control group (n = 81). The general data of the two groups were compared, and Logistic regression analysis was performed to identify factors influencing the loss of ROM after elbow joint release surgery in elderly patients with traumatic elbow stiffness. A risk prediction model was also established based on the identified risk factors.
Multivariate Logistic regression analysis unveiled that high-energy injury (odds ratio (OR) = 4.632, 95% confidence interval (CI) = 1.363∼15.737), open injury (OR = 3.967, 95% CI = 1.308∼12.029), passive rehabilitation method (OR = 10.115, 95% CI = 1.113∼91.924), injury-to-release surgery time of ≥6 months (OR = 5.983, 95% CI = 1.677∼21.350), heterotopic ossification traumatic factors (OR = 5.409, 95% CI = 1.316∼22.224), and complex elbow joint damage (OR = 5.658, 95% CI = 1.457∼21.962) were all independent risk factors for ROM loss following elbow joint release surgery in elderly patients with traumatic elbow stiffness (p < 0.05). A risk prediction model was developed based on these factors, indicating a predictive sensitivity of 73.17%, a specificity of 69.14%, and an area under the curve (AUC) of 0.767.
Clinically, the independent risk factors identified in this study should be closely monitored. Furthermore, treatment should be tailored based on the specific conditions of the patient, and high-risk factors should be effectively controlled to reduce the risk of ROM loss after elbow joint release surgery in traumatic elbow joint stiffness elderly patients.
肘部关节松解术常用于治疗肘部关节僵硬。虽然它可以恢复肘部关节的活动度，但一些患者在手术后仍可能出现活动度（ROM）丧失。因此，本研究旨在探讨影响创伤性肘部僵硬老年患者肘部关节松解术后 ROM 丧失的因素。
这是一项回顾性研究，纳入了 2023 年 1 月至 2024 年 4 月在汉中市中心医院接受肘部关节松解术的 122 例创伤性肘部僵硬老年患者。将出现活动度丧失的患者纳入观察组（n=41），将未出现活动度丧失的患者纳入对照组（n=81）。比较两组的一般资料，采用 Logistic 回归分析识别影响创伤性肘部僵硬老年患者肘部关节松解术后 ROM 丧失的因素，并基于识别出的危险因素建立风险预测模型。
多因素 Logistic 回归分析揭示，高能损伤（比值比（OR）=4.632，95%置信区间（CI）=1.36315.737）、开放性损伤（OR=3.967，95%CI=1.30812.029）、被动康复方法（OR=10.115，95%CI=1.11391.924）、损伤至松解手术时间≥6 个月（OR=5.983，95%CI=1.67721.350）、异位骨化创伤因素（OR=5.409，95%CI=1.31622.224）和复杂肘部关节损伤（OR=5.658，95%CI=1.45721.962）均为影响创伤性肘部僵硬老年患者肘部关节松解术后 ROM 丧失的独立危险因素（p<0.05）。基于这些因素建立了风险预测模型，提示其预测灵敏度为 73.17%，特异性为 69.14%，曲线下面积（AUC）为 0.767。
临床上，应密切监测本研究确定的独立危险因素。此外，应根据患者的具体情况进行治疗，并有效控制高危因素，以降低创伤性肘部僵硬老年患者肘部关节松解术后 ROM 丧失的风险。
