临床误诊误治2025，Vol.38Issue(10)：59-65,72,8.DOI:10.3969/j.issn.1002-3429.2025.10.010
股骨近端髓内钉治疗不稳定型股骨转子间骨折术后髋关节功能康复的预测模型构建及评价
Construction and Evaluation of a Predictive Model for Postoperative Hip Functional Recovery in Patients with Unstable Femoral Intertrochanteric Fractures Treated with Proximal Femoral Intramedullary Nail
摘要
Abstract
Objective To construct a predictive model for postoperative hip functional recovery in patients with unsta-ble femoral intertrochanteric fractures treated with proximal femoral intramedullary nail,and to validate it.Methods A total of 361 patients with unstable femoral intertrochanteric fractures who underwent proximal femoral intramedullary nail treatment from January 2023 to February 2024 were selected.Among them,3 patients were lost to follow-up,6 patients were non-compliant in the questionnaire survey,and 352 patients were ultimately included.Patients were assigned to two groups based on their postoperative rehabilitation status:the good recovery group(n=276)and the poor recovery group(n=76).Multiva-riate Logistic regression analysis was used to identify the factors influencing poor hip functional recovery in patients.A nomo-gram prediction model was constructed and evaluated.Results Age,osteoporosis,American Society of Anesthesiologists classification,delayed weight-bearing,phobia of movement,postoperative complications,low levels of vascular endothelial growth factor,and low levels of platelet-derived growth factor were risk factors for poor hip functional recovery in patients with unstable femoral intertrochanteric fractures treated with proximal femoral intramedullary nail.Emergency surgery within 24 h,compliance with functional exercise,and self-efficacy were protective factors(P＜0.05,P＜0.01).Based on this,a nomo-gram model was constructed to predict poor postoperative hip functional recovery in patients.The validation results showed that the model had high accuracy,good predictive performance,and clinical utility.Conclusion There are numerous factors that influence the postoperative hip functional recovery of patients with unstable femoral intertrochanteric fractures.Based on this,the nomogram model constructed exhibits high accuracy,excellent predictive value,and clinical utility.关键词
不稳定型股骨转子间骨折/髓内钉/康复/危险因素/列线图/预测模型Key words
Unstable femoral intertrochanteric fracture/Intramedullary nail/Rehabilitation/Risk factors/Nomo-gram/Predictive model分类
临床医学引用本文复制引用
韩双杨,赵李奔,陆泉秀..股骨近端髓内钉治疗不稳定型股骨转子间骨折术后髋关节功能康复的预测模型构建及评价[J].临床误诊误治,2025,38(10):59-65,72,8.基金项目
2020年度河北省医学科学研究重点课题(20201374) （20201374）
