Lin Ji,Pan Yuancheng,Lin Ran,et al.Risk factors for avascular necrosis after lateral humeral condyle fracture[J].Journal of Clinical Pediatric Surgery,,():1029-1034.[doi:10.3760/cma.j.cn101785-202405048-006]
Risk factors for avascular necrosis after lateral humeral condyle fracture
- Keywords:
- Lateral Humeral Condyle Fracture; Avascular Necrosis; Risk Factors; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the risk factors for avascular necrosis (AVN) after surgery for lateral humeral condyle fracture in children. Methods From January 2018 to December 2021,retrospective analysis was conducted for the relevant clinical data of 337 children with lateral humeral condyle fractures.Follow-up radiography was performed for assessing the occurrence of AVN of lateral humeral condyle.Univariate Logistic analysis was performed for age,gender,sideness of fracture,body mass index (BMI),Weiss classification,initial displacement,fracture fragment rotation,degree of postoperative displacement,time from injury to surgery,duration of surgery,intraoperative arthrography and reduction mode.Variables with P≤0.1 in univariate analysis were further examined.And multivariate Logistic regression was utilized for identifying independent risk factors for AVN.Receiver operator characteristic (ROC) curve analysis was employed for validating the model and determining the optimal predictive cutoff value. Results AVN occurred postoperatively in 2.1%(7/337).Univariate analysis indicated that statistically significant inter-group differences (P≤0.1) existed in age, initial displacement distance and fracture fragment rotation rate (6/7 vs.76/330).No statistically significant differences existed in gender,sideness of fracture,BMI,Weiss classification,degree of postoperative displacement,time from injury to surgery,operative duration,intraoperative imaging or reduction mode (P>0.05).Multivariate Logistic regression analysis revealed that younger age (OR=1.953,95%CI:1.065-3.571) and fracture fragment rotation (OR=29.413,95%CI:1.138-760.015) were independent risk factors for the occurrence of AVN.The area under the ROC curve (AUC) was 0.7766 and 2.5 years of age was an optimal cutoff value for this predictive model.Chi-square test showed a statistically significant difference (P=0.017) in the incidence of AVN between children aged <2.5 year and those aged 2.5 year or above (7.0% vs.1.1%). Conclusions Younger age and fragment rotation are independent risk factors for AVN after surgery for lateral humeral condyle fracture.An age of 2.5 year may be used as an optimal cutoff for predicting the occurrence of AVN.
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Memo
收稿日期:2024-5-23。
基金项目:福建省创伤骨科急救与康复临床医学研究中心(2020Y2014);福建省福州市临床重点专科(20220104)
通讯作者:陈顺有,Email:csy508@163.com