Research: Construction and validation of elbow function prediction model after supracondylar humerus fracture in children

Abstract

This article’s objectives are to develop a model to predict children’s recovery of elbow function following supracondylar fracture, analyze the risk factors affecting those children’s elbow function after surgery, and propose a individualized treatment strategy for elbow function in various children. We retrospectively analyzed clinical data from 410 children with supracondylar humerus fracture. A modeling set and a validation set of kids in the included studies were arbitrarily split into 2 groups on a 7:3 basis. To identify statistically significant risk factors, univariate logistic regression analysis was used. Then, multivariate logistic regression was used with the risk factors, and the best logistic regression model was chosen based on sensitivity and accuracy to create a nomogram; A total of 410 children were included in the study according to the inclusion criteria. Among them, there were 248 males and 162 females, and the fracture type: 147 cases of type IIb and 263 cases of type III. There were no significant changes in the afflicted limb’s lateral difference, surgical method, onset season, and number of K-wires, according to univariate logistic regression analysis. Age (P < .001), weight (P < .001), height (P < .001), preoperative elbow soft tissue injury (OR = 1.724, 95% CI: 1.040–2.859, P = .035), sex (OR = 2.220, 95% CI: 1.299–3.794, P = .004), fracture classification (Gartland IIb) (OR = 0.252, 95% CI: 0.149–0.426, P < .001), no nerve injury before surgery (OR = 0.304, 95% CI: 0.155–0.596, P = .001), prying technique (OR = 0.464, 95% CI: 0.234–0.920, P = .028), postoperative daily light time > 2 hours (OR = 0.488, 95% CI: 0.249–0.955, P = .036) has a significant difference in univariate analysis; Multivariate regression analysis yielded independent risk factors: fracture classification; No nerve injury before surgery; The daily light duration after surgery was > 2 hours; soft tissue injury; Age, postoperative cast fixation time. The establishment of predictive model is of significance for pediatric orthopedic clinicians in the daily diagnosis and treatment of supracondylar humerus fracture.