基于Logistic回归分析肱骨近端骨折患者术后并发肱骨头内翻的因素研究

Study on the Factors of Postoperative Varus of Humeral Head in Patients with Proximal Humeral Fracture Based on Logistic Regression Analysis

目的:探讨肱骨近端骨折患者术后并发肱骨头内翻的影响因素。方法:选取2020年1月-2021年5月某院接收的98例肱骨近端骨折患者作为研究对象,患者均接受切开复位锁定钢板内固定术治疗,记录随访6个月期间肱骨近端骨折患者发生肱骨头内翻情况;设计患者基线资料填写表,询问并记录研究所需资料,将可能的影响因素纳入,分析可能导致肱骨近端骨折患者术后并发肱骨头内翻的影响因素。结果:随访6个月期间,98例肱骨近端骨折患者经评估,术后发生肱骨头内翻28例,占28.57%(28/98);发生组手术入路方式、骨密度、骨折分型、复位质量与未发生组比较,差异有统计学意义(P<0.05);组间其他基线资料比较,差异无统计学意义(P>0.05);经Logistic回归分析,结果显示,劈三角肌入路、Ⅲ~Ⅳ型骨折、复位质量不满意均是肱骨近端骨折患者术后并发肱骨头内翻的危险因素(OR>1,P<0.05),骨密度高是肱骨近端骨折患者术后并发肱骨头内翻的保护因素(OR<1,P<0.05)。结论:肱骨近端骨折患者术后并发肱骨头内翻可能与劈三角肌入路、Ⅲ~Ⅳ型骨折、复位质量不满意、骨密度低等因素有关。

Objective:To investigate the influencing factors of postoperative varus of humeral head in patients with proximal humeral fracture.Methods:98 patients with proximal humeral fracture treated in a hospital from January 2020 to May 2021 were selected as the research subjects,and all patients were treated with open reduction and locking plate internal fixation.The varus of humeral head in patients with proximal humeral fracture was recorded during 6 months of follow-up;The baseline data filling form of patients was designed,the information required for the study was asked and recorded,the possible influencing factors were included,and then the influencing factors that might lead to postoperative varus of humeral head in patients with proximal humeral fracture were analyzed.Results:During the 6 months of follow-up,98 patients with proximal humeral fracture were evaluated.28 cases(28/98)had humeral head varus after operation;There were statistically significant differences in surgical approach methods,bone mineral density,fracture classification and reduction quality between the occurrence group and the non occurrence group(P<0.05).Tthere was no statistically significant difference in the other baseline data between the two groups(P>0.05).Logistic regression analysis showed that deltoid splitting approach,type III-IV fracture and unsatisfactory reduction quality were the risk factors for postoperative varus of humeral head in patients with proximal humeral fracture(OR>1,P<0.05),and high bone mineral density was a protective factor for postoperative varus of humeral head in patients with proximal humeral fracture(OR<1,P<0.05).Conclusion:The postoperative varus of humeral head in patients with proximal humeral fracture may be related to the deltoid splitting approach,typeⅢ~Ⅳfracture,unsatisfactory reduction quality and low bone mineral density.