Analysis of factors influencing postoperative delayed fracture healing in children with long stem fractures of the extremities
Objective:To explore the influencing factors of postoperative delayed healing of fractures of the long diaphysis of the ex-tremities in children.Methods:Basic data of 120 children with long diaphysis fractures of the extremities admitted to a hospital from March 2021 to April 2022 were retrospectively analysed.The 120 children were divided into a delayed healing group(n=26)and a normal healing group(n=94)according to the diagnostic criteria of delayed fracture healing,and the levels of 25-OH-VD and bone metabolic indexes(PTH,PINP,β-CTX)were detected in the postoperative period and were compared.The basic data of the children were collected(gender,age,weight,place of residence,cause of fracture,site and type,etc.),and the Osteoporosis Self-Efficacy Scale(OSES)and the Osteoporotic Fracture Diagnostic Guidelines were applied to assess the level of exercise self-efficacy and the de-gree of bone loss in the children.Univariate and logistic regression models were used to identify the independent factors affecting post-operative delayed healing in children with long trunk fractures of the extremities,and the diagnostic efficacy was analysed by plotting ROC curves.Results:There were no statistically significant differences between the two groups in terms of gender,age,weight,place of residence,cause,site and type of fracture(P>0.05),but the differences between the two groups in terms of whether the exercise self-efficacy was good or not,whether there was a combination of osteoporosis or not,postoperative infections,and the levels of serum 25-OH-VD,PTH,PINP,and β-CTX in postoperative period were statistically significant(P<0.05).Mulitiple factor Logistic regres-sion analysis indicated that exercise self-efficacy(P=0.029,OR=2.032),comorbid osteoporosis(P=0.001,OR=5.114),postop-erative infection(P=0.035,OR=1.445),postoperative serum 25-OH-VD(P=0.003,OR=1.125),PTH(P=0.000,OR=1.132),PINP(P=0.023,OR=1.215),and β-CTX(P=0.008,OR=5.966)levels were independent influencing factors for post-operative delayed healing in children with long stem fractures of the extremities(all P<0.05).The constructed risk assessment model ROC curves showed that the joint detection of the above factors had the highest AUC value 0.991,and the sensitivity and specificity were 96.55%and 89.65%,respectively.Conclusion:Serum 25-OH-VD,PTH,PINP,β-CTX levels,exercise self-efficacy,osteopo-rosis,and postoperative infections were the independent influencing factors of delayed healing in children with long stem fractures of the extremities.In clinical practice,the relevant factors should be effectively controlled and targeted preventive measures should be applied to reduce the risk of delayed fracture healing.
Long stem fractures of the extremitiesChildrenDelayed healingInfluencing factorsSerum 25-hydroxyvitamin DBone metabolism
万方数据
维普
