Analysis of risk factors for refracture after proximal femoral nail antirotation internal fixation in elderly patients with osteoporotic intertrochanteric femur fractures and establishment of a prediction model
Objectives:To identify the risk factors for refracture after proximal femoral nail antirotation(PFNA)internal fixation in elderly patients with osteoporotic intertrochanteric femur fractures,and to develop a predictive nomogram model.Methods:A retrospective analysis was conducted on clinical data of 123 patients who underwent PFNA internal fixation at Taixing People's Hospital Affiliated to Bengbu Medical University.Patients were divided into refracture(18 cases)and non-refracture(105 cases)groups based on postoperative peri-implant refracture.Demographic and clinical data were collected,including sex,age,height,weight,body mass index(BMI),the presence of chronic internal disease,Singh index,fracture classification,fracture reduction status,time to weight-bearing,tip-apex distance(TAD),anti-osteoporosis treatment,thickness of the lateral wall and medial wall reduction status.Univariate and multivariate logistic regression analysis was conducted to identify the independent risk factors for refracture,and to establish and validate a predictive model.Results:Univariate logistic regression analysis identified that age,the presence of chronic internal disease,Singh index,TAD,anti-osteoporosis treatment and lateral wall thickness were related factors affecting refracture after PFNA internal fixation(all P<0.05).These factors were subsequently included in the multivariate logistic regression analysis.The results confirmed that the presence of chronic internal disease,Singh index,TAD,anti-osteoporosis treatment,and lateral wall thickness were independent risk factors for refracture(all P<0.05).A nomogram was established based on the results of the multivariate logistic regression and internally validated.The ROC analysis revealed that the AUC of the nomogram was 0.965(95%CI:0.927-1.000),indicating excellent discrimination.The calibration curve showed good predictive ability of the model.Conclusions:The presence of chronic internal diseases,Singh index,TAD,anti-osteoporosis treatment,and lateral wall thickness are independent risk factors for refracture after PFNA internal fixation in elderly patients with osteoporotic intertrochanteric fractures.The predictive model based on these key risk factors can accurately assess the risk of refracture,and holds significant clinical value with potential for widespread application.
Elderly Intertrochanteric Femur FractureOsteoporosisRefractureRisk FactorPredictive Model
万方数据
维普
