关键词: 有限接触动力加压钢板； 肱骨骨折； 预后； Nomogram

Abstract: Objective To collect the clinical data of patients and construct a nomogram model to predict the prognosis of patients with humeral fracture treated with limited contact dynamic compression plate(LC-DCP).Methods A total of 372 patients with humeral fractures who received LC-DCP in our hospital from January 2013 to December 2020 weree randomly divided into a modeling cohort(n=260) and a validation cohort(n=112) according to 7∶3.Logistic regression model was used to analyze the data of the modeling cohort,and a Nomogram model was established according to the results of the influencing factors of poor prognosis of LC-DCP treatment for patients with humerus fractures.Nomogram was validated internally(modeling cohort) and externally(validation cohort) using calibration curve and ROC curve.Results The incidence of poor prognosis was 20.43%(76 / 372) in 372 patients with humeral fracture treated with LC-DCP.Univariate analysis showed that the age, incision length, intraoperative blood loss, time to start functional exercise and postoperative complications in the good prognosis group were significantly lower than those in the poor prognosis group (P<0.05).Multivariate Logistic regression analysis showed that age ≥60 years old, incision length ≥5 cm, intraoperative blood loss ≥110 ml, start time of functional exercise ≥7 days after surgery, and postoperative complications were independent risk factors for the efficacy of LC-DCP in the treatment of proximal humeral fracture (P<0.05).The calibration curve and ROC curve of the Nomogram model showed that the slope of the calibration curve for internal verification and external verification was close to 1, and the area under ROC for internal verification and external verification was 0.823 and 0.839 respectively.Conclusion The Nomogram model established in this study based on postoperative complications,intraoperative blood loss,age,postoperative functional exercise start time and incision length is effective and discriminative.

Key words: LC-DCP therapy; humeral fracture; prognosis; Nomogram