临床小儿外科杂志2024，Vol.23Issue(11)：1029-1034,6.DOI:10.3760/cma.j.cn101785-202405048-006
儿童肱骨外髁骨折手术后外髁缺血性坏死的危险因素分析
Risk factors for avascular necrosis after lateral humeral condyle fracture
摘要
Abstract
Objective To explore the risk factors for avascular necrosis(AVN)after surgery for lateral humeral condyle fracture in children.Methods From January 2018 to December 2021,retrospective analysis was conducted for the relevant clinical data of 337 children with lateral humeral condyle fractures.Follow-up ra-diography was performed for assessing the occurrence of AVN of lateral humeral condyle.Univariate Logistic a-nalysis was performed for age,gender,sideness of fracture,body mass index(BMI),Weiss classification,initial displacement,fracture fragment rotation,degree of postoperative displacement,time from injury to surgery,dura-tion of surgery,intraoperative arthrography and reduction mode.Variables with P≤0.1 in univariate analysis were further examined.And multivariate Logistic regression was utilized for identifying independent risk factors for AVN.Receiver operator characteristic(ROC)curve analysis was employed for validating the model and de-termining the optimal predictive cutoff value.Results AVN occurred postoperatively in 2.1％(7/337).Uni-variate analysis indicated that statistically significant inter-group differences(P≤0.1)existed in age[2(1,4)vs.4(3,6)year],initial displacement distance[14.8(11.3,15.8)vs.6.1(3.7,12.1)mm]and fracture frag-ment rotation rate(6/7 vs.76/330).No statistically significant differences existed in gender,sideness of frac-ture,BMI,Weiss classification,degree of postoperative displacement,time from injury to surgery,operative dura-tion,intraoperative imaging or reduction mode(P＞0.05).Multivariate Logistic regression analysis revealed that younger age(OR=1.953,95％CI:1.065-3.571)and fracture fragment rotation(OR=29.413,95％CI:1.138-760.015)were independent risk factors for the occurrence of AVN.The area under the ROC curve(AUC)was 0.7766 and 2.5 years of age was an optimal cutoff value for this predictive model.Chi-square test showed a statistically significant difference(P=0.017)in the incidence of AVN between children aged＜2.5 year and those aged 2.5 year or above(7.0％vs.1.1％).Conclusions Younger age and fragment rotation are independent risk factors for AVN after surgery for lateral humeral condyle fracture.An age of 2.5 year may be used as an optimal cutoff for predicting the occurrence of AVN.关键词
肱骨外髁骨折/缺血性坏死/危险因素/外科手术/儿童Key words
Lateral Humeral Condyle Fracture/Avascular Necrosis/Risk Factors/Surgical Proce-dures,Operative/Child引用本文复制引用
林基,潘源城,林然,黄鸿哲,林伟凡,陈顺有..儿童肱骨外髁骨折手术后外髁缺血性坏死的危险因素分析[J].临床小儿外科杂志,2024,23(11):1029-1034,6.基金项目
福建省创伤骨科急救与康复临床医学研究中心(2020Y2014) （2020Y2014）
福建省福州市临床重点专科(20220104) Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Or-thopedic Trauma(2020Y2014) （20220104）
Key Clinical Specialty Discipline Construction Program of Fuzhou Municipali-ty(20220104) （20220104）
