Umer Muhammad Rizwan, Asghar Areeba, Zar Nawaz Muhammad Abu, Maryam Fokehah, Javid Safeer Ahmad, Hassan Muddasir Reyaz, Akbar Amna, Zahid Areeba, K Mariam
Trauma Surgery, Royal Sussex County Hospital, Brighton, GBR.
Medicine and Surgery, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, GBR.
Cureus. 2025 Jul 23;17(7):e88595. doi: 10.7759/cureus.88595. eCollection 2025 Jul.
Advancements in fracture fixation have significantly reshaped orthopedic trauma management by improving mechanical stability and promoting biological healing. This retrospective observational study assessed clinical and biomechanical outcomes in 500 patients who underwent surgical fixation for radiologically confirmed fractures. Patients were categorized into two groups: Group A received conventional fixation methods (e.g., standard plates and screws), while Group B was treated with advanced systems, including locking plates, intramedullary nails, minimally invasive percutaneous osteosynthesis (MIPO), and bioresorbable implants. Data analysis included 50 variables spanning demographics, clinical profiles, imaging, laboratory results, implant details, and postoperative outcomes. Statistical methods such as t-tests, chi-square, Mann-Whitney U, Kruskal-Wallis, Kaplan-Meier survival analysis, and multiple regression models were performed using IBM SPSS Statistics for Windows, Version 27.0 (Released 2019; IBM Corp., Armonk, NY, US). The study found that advanced fixation techniques resulted in significantly faster healing (12.4 vs. 14.9 weeks, p < 0.001), earlier mobilization (p = 0.003), and better three-month functional outcomes, with 80.1% in Group B achieving good to excellent recovery compared to 58.2% in Group A (p < 0.001). The complication rate was notably lower in the advanced group (10.8% vs. 20.4%, p = 0.003). Regression analysis identified implant type, vitamin D levels, and diabetes status as key predictors of healing duration, complication risk, and functional recovery. Predictive models demonstrated strong performance: a linear regression model for healing time (R² = 0.38, p < 0.001), a logistic regression model for complications (accuracy = 71.6%), and an ordinal regression model for functional outcomes (Nagelkerke R² = 0.41, p < 0.001). These findings support the clinical benefits of modern fixation systems and highlight the importance of integrating biomechanical choices with patient-specific health indicators to enhance fracture management outcomes.
骨折固定技术的进步通过提高机械稳定性和促进生物愈合，显著重塑了骨科创伤的治疗方式。这项回顾性观察研究评估了500例经放射学确诊骨折并接受手术固定的患者的临床和生物力学结果。患者被分为两组：A组采用传统固定方法（如标准钢板和螺钉），而B组采用先进系统治疗，包括锁定钢板、髓内钉、微创经皮接骨术（MIPO）和生物可吸收植入物。数据分析包括50个变量，涵盖人口统计学、临床特征、影像学、实验室结果、植入物细节和术后结果。使用IBM SPSS Statistics for Windows 27.0版（2019年发布；IBM公司，美国纽约州阿蒙克）进行t检验、卡方检验、曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验、 Kaplan-Meier生存分析和多元回归模型等统计方法。研究发现，先进的固定技术导致愈合明显更快（12.4周对14.9周，p<0.001），更早活动（p = 0.003），以及三个月时功能结果更好，B组80.1%的患者恢复良好至优秀，而A组为58.2%（p<0.001）。先进组的并发症发生率明显更低（10.8%对20.4%，p = 0.003）。回归分析确定植入物类型、维生素D水平和糖尿病状态是愈合时间、并发症风险和功能恢复的关键预测因素。预测模型表现出色：愈合时间的线性回归模型（R² = 0.38，p<0.001），并发症的逻辑回归模型（准确率 = 71.6%），以及功能结果的有序回归模型（Nagelkerke R² = 0.41，p<0.001）。这些发现支持了现代固定系统的临床益处，并强调了将生物力学选择与患者特定健康指标相结合以提高骨折治疗效果的重要性。
