A Study on the Efficacy of Rasmussen Radiological Score and Anatomical Parameters Based on CT in Predicting the Efficacy of Internal Fixation Surgery for Tibial Plateau Fractures
Objective Exploring the efficacy of CT based Rasmussen radiological scoring and anatomical parameters in predicting the efficacy of internal fixation surgery for tibial plateau fractures.Methods Clinical data of 200 patients with internal fixation of tibial plateau fracture treated in our hospital from February 2020 to August 2022 were retrospectively analyzed,and they were divided into excellent group(n=169)and non-excellent group(n=31)according to the curative effect 6 months after operation.Baseline data of the two groups were compared based on CT Rasmussen radiology score,lateral posterior inclination Angle of tibial plateau,knee space width,varus Angle,platform collapse,femoro-tibial Angle,and the correlation between CT results and efficacy was analyzed by Spearman.Multivariate Logistic regression was used to analyze the effects of Ct-based Rasmussen radiological score and anatomical parameters on the therapeutic effect.Receiver Operating characteristic curve(ROC)analysis of Ct-based Rasmussen radiological scores and anatomical parameters and their combined efficacy in predicting the outcome of internal fixation of tibial plateau fractures.Results The proportion of patients with meniscus injury in excellent group was lower than that in non-excellent group(P＜0.05).The Rasmussen radiological score of the excellent group was higher than that of the non-excellent group,and the posterior inclination Angle,knee space width,varus Angle and platform collapse were lower than those of the non-excellent group(P＜0.05).Correlation analysis showed that Rasmussen radiology score was positively correlated with the curative effect(r=0.703),while the posterior inclination Angle(r=-0.659),knee space width(r=-0.621),varus Angle(r=-0.731)and platform collapse(r=-0.617)were negatively correlated with the curative effect(all P＜0.05).Logistic regression analysis showed that after correcting for meniscus injury,Rasmussen radiological score,posterior inclination Angle,knee space width,varus Angle and platform collapse were still independent factors related to the curative effect(all P＜0.05).The area under ROC(AUC)of Rasmussen radiological score,back inclination Angle,knee joint space width,varus Angle and platform collapse prediction efficacy were 0.779,0.818,0.757,0.815 and 0.809,respectively(all P＜0.05),and the AUC of back inclination Angle was the largest.The ROC curve of Rasmussen radiological score combined with anatomical parameters to predict the curative effect showed that the AUC was 0.904(95％CI:0.854～0.941),which was larger than the backward Angle(Z=0.395,P＜0.05),the prediction sensitivity was 87.10％,and the specificity was 86.98％.Condusion Rasmussen radiological score,posterior inclination Angle,knee space width,varus Angle and plateau collapse are independent factors related to the efficacy of internal fixation of tibial plateau fracture.The combined detection of these parameters based on CT may be used as a prediction scheme for the efficacy of internal fixation of tibial plateau fracture,providing quantitative reference information for intraoperative and postoperative management.
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