影响尺骨冠突骨折患者术后肘关节功能恢复的因素分析和预测模型构建  

Analysis of Factors Affecting Elbow Joint Function Recovery in Patients with Ulna Coronoid Process Fracture after Operation and Construction of Prediction Model

作　　者：李忠[1] 靳云乔[1] 李青 姚彦霞 孟秀梅 LI Zhong;JIN Yunqiao;LI Qing;YAO Yanxia;MENG Xiumei(Hengshui Fourth People's Hospital,Hengshui 053000,Hebei China)

机构地区：[1]衡水市第四人民医院,河北衡水053000

出　　处：《中国中医骨伤科杂志》2024年第5期66-71,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：河北省衡水市科技计划项目(2022014006Z)。

摘　　要：目的:探讨影响尺骨冠突骨折患者术后肘关节功能恢复的因素,构建预测模型。方法:回顾性选择2019年6月至2022年6月收治的208例尺骨冠突骨折患者,所有患者均行切开复位内固定治疗,术后随访12个月,根据末次随访Mayo肘关节功能评分(MEPS)将患者分为恢复不良组(48例)和恢复优良组(160例)。收集临床资料,多因素Logistic回归分析影响尺骨冠突骨折患者术后肘关节功能恢复的因素,基于Logistic回归构建预测模型,采用受试者工作特征(ROC)曲线和H-L检验预测模型的效能。结果:恐怖三联征、O’Driscoll分型Ⅰ型是影响尺骨冠突骨折患者术后肘关节功能恢复的危险因素,差异有统计学意义(P<0.05),手术后侧入路、支撑钢板内固定是保护因素,差异有统计学意义(P<0.05)。预测模型预测尺骨冠突骨折患者术后肘关节功能恢复不良的曲线下面积为0.808,差异有统计学意义(95%CI=0.748~0.859,P<0.05);灵敏度、特异度分别为81.25%和85.00%,H-L检验预测模型具有较好的符合度,差异无统计学意义(P>0.05)。结论:恐怖三联征、O’Driscoll分型、手术入路、内固定方式与尺骨冠突骨折患者术后肘关节功能恢复有关,据此建立预测模型可较好地预测肘关节功能恢复不良的风险。Objective:To investigate the factors affecting elbow joint function recovery in patients with ulna coronoid process fracture after operation,and to establish a predictive model.Methods:208 patients with ulnar coronoid process fracture admitted of our hospital from June 2019 to June 2022 were retrospectively selected.All patients were treated with open reduction and internal fixation,and were followed up for 12 months.Patients were divided into poor recovery group(48 cases)and good recovery group(160 cases)according to Mayo elbow performance score(MEPS)at last follow-up.The clinical data were collected,and the factors affecting the functional recovery of elbow joint in patients with ulnar coronoid process fracture were analyzed by multi-factor Logistic regression,and the prediction model was built based on Logistic regression.Receiver operating characteristic(ROC)curve and H-L test the efficiency of the prediction model.Results:Terror triad and O'Driscoll type I were the risk factors for elbow function recovery(P<0.05).Posterior approach and internal fixation with supporting plate were the protective factors(P<0.05).The area under the curve predicted by the prediction model was 0.808(95%CI=0.748-0.859,P<0.05),and the sensitivity and specificity were 81.25%and 85.00%,respectively.The H-L test predicted that the prediction model had a good agreement(P>0.05).Conclusion:Terror triad,O'Driscoll classification,surgical approach and internal fixation are related to elbow joint function recovery in patients with ulnar coronoid process fracture.Based on this,a prediction model can better predict the risk of poor elbow joint function recovery.

关 键 词：尺骨冠突骨折 肘关节功能 危险因素 预测模型 

分 类 号：R683.41[医药卫生—骨科学]