Factors influencing elbow function after internal fixation of complex distal humeral fractures in adults

影响成人复杂肱骨远端骨折内固定术后肘关节功能的因素

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Abstract

Background The study aimed to analyze the clinical factors influencing the surgical outcomes of distal humeral fractures in adults, providing a reference for improving prognosis. Methods from January 2017 to December 2023, clinical data from 130 patients were collected; 91 met inclusion criteria and were included in the analysis. Factors such as age, gender, BMI, laterality, causes of injury, whether the injury was open, fracture classification, use of arch support, and the quality of fracture reduction were analyzed for their impact on outcomes. Results Ninety-one patients were included in the study. Evaluation showed 67 patients had excellent outcomes, 11 had good outcomes, 10 fair, and 3 poor, with an excellent/good rate of 85.71%. Univariate analysis indicated that use of arch support, number of distal fragment screws, early joint range of motion, time to initiation of postoperative exercises, and duration of hospitalization were all significantly associated with outcomes (p < 0.05). Multivariate linear regression analysis revealed that the use of arch support, the number of screws, postoperative functional exercise, and duration of hospitalization were independent factors influencing surgical outcomes (p < 0.05). Correlation analysis showed that arch support, number of screws, postoperative exercise, patient satisfaction, and hospitalization duration were all significantly associated with functional outcome (p < 0.05). Conclusion Prolonged hospitalization was a risk factor for poor outcome, whereas use of arch support, postoperative functional exercise, and additional distal screws were protective factors. These findings may improve clinical management of distal humeral fractures.

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