肘关节外伤性僵硬老年患者肘关节松解手术后活动范围丧失的影响因素分析

IF 0.9 4区 医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2024-01-01 DOI:10.62713/aic.3576
Lipeng Zhang, Fufeng Qu, Xudong Zhao
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引用次数: 0

摘要

目的:肘关节松解手术通常用于治疗肘关节僵硬。虽然手术可以恢复肘关节的活动度,但部分患者术后仍可能出现活动度(ROM)下降的情况。因此,本研究旨在探讨影响创伤性肘关节僵硬老年患者肘关节松解手术后ROM损失的因素:本回顾性研究纳入了2023年1月至2024年4月在汉中市中心医院接受肘关节松解手术的122例老年外伤性肘关节僵硬患者。有活动范围缺损的患者被纳入观察组(41 人),无活动范围缺损的患者被纳入对照组(81 人)。比较两组患者的一般数据,并进行逻辑回归分析,以确定影响老年外伤性肘关节僵硬患者肘关节松解手术后活动度丧失的因素。结果显示:多变量Logistic回归分析发现了影响老年外伤性肘关节僵硬患者肘关节松解术后ROM丧失的因素,并根据发现的风险因素建立了风险预测模型:多变量逻辑回归分析显示,高能量损伤(几率比(OR)= 4.632,95% 置信区间(CI)= 1.363∼15.737)、开放性损伤(OR = 3.967,95% CI = 1.308∼12.029)、被动康复方法(OR = 10.115,95% CI = 1.113∼91.924)、损伤到松解手术时间≥6 个月(OR = 5.983,95% CI = 1.677∼21.350)、异位骨化外伤因素(OR = 5.409,95% CI = 1.316∼22.224)和复杂性肘关节损伤(OR = 5.658,95% CI = 1.457∼21.962)均为老年外伤性肘关节僵硬患者肘关节松解手术后 ROM 损失的独立危险因素(P < 0.05)。根据这些因素建立的风险预测模型显示,预测灵敏度为73.17%,特异度为69.14%,曲线下面积(AUC)为0.767:在临床上,应密切关注本研究中发现的独立风险因素。结论:临床上,应密切监测本研究中发现的独立危险因素,并根据患者的具体情况进行针对性治疗,有效控制高危因素,以降低外伤性肘关节僵硬老年患者肘关节松解术后ROM丧失的风险。
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Analysis of Factors Affecting Range of Motion Loss after Elbow Joint Release Surgery in Elderly Patients with Traumatic Elbow Stiffness.

Aim: Elbow joint release surgery is commonly used to treat elbow joint stiffness. Though it can restore elbow joint mobility, some patients may still experience range of motion (ROM) loss after surgery. Therefore, this study aims to explore the factors influencing ROM loss after elbow joint release surgery in elderly patients with traumatic elbow stiffness.

Methods: This retrospective study included 122 elderly patients with traumatic elbow stiffness who underwent elbow joint release surgery at Hanzhong Central Hospital from January 2023 to April 2024. The patients with range of motion loss were included in the observation group (n = 41), and those without range of motion loss were placed in the control group (n = 81). The general data of the two groups were compared, and Logistic regression analysis was performed to identify factors influencing the loss of ROM after elbow joint release surgery in elderly patients with traumatic elbow stiffness. A risk prediction model was also established based on the identified risk factors.

Results: Multivariate Logistic regression analysis unveiled that high-energy injury (odds ratio (OR) = 4.632, 95% confidence interval (CI) = 1.363∼15.737), open injury (OR = 3.967, 95% CI = 1.308∼12.029), passive rehabilitation method (OR = 10.115, 95% CI = 1.113∼91.924), injury-to-release surgery time of ≥6 months (OR = 5.983, 95% CI = 1.677∼21.350), heterotopic ossification traumatic factors (OR = 5.409, 95% CI = 1.316∼22.224), and complex elbow joint damage (OR = 5.658, 95% CI = 1.457∼21.962) were all independent risk factors for ROM loss following elbow joint release surgery in elderly patients with traumatic elbow stiffness (p < 0.05). A risk prediction model was developed based on these factors, indicating a predictive sensitivity of 73.17%, a specificity of 69.14%, and an area under the curve (AUC) of 0.767.

Conclusions: Clinically, the independent risk factors identified in this study should be closely monitored. Furthermore, treatment should be tailored based on the specific conditions of the patient, and high-risk factors should be effectively controlled to reduce the risk of ROM loss after elbow joint release surgery in traumatic elbow joint stiffness elderly patients.

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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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