胫骨干骨折伴后踝骨折患者临床特点及预测模型构建OA

Objective To analyze the clinical features of patients with tibial shaft fractures combined with posterior malleolar fracture and to constructional model for the fractures.Methods A retrospective analysis was conducted on the clinical data of the pa-tients with tibial shaft fractures who underwent preoperative X-ray and CT examinations at the 971th Hospital of PLA Navy from January 2019 to December 2024.A total of 167 patients were included in this study,comprising 108 males and 59 females,with a mean age of(46.6±16.2)years.The patients were divided into a combined posterior malleolar fracture group(n=63)and an isolated tibial shaft fracture group(n=104)based on the presence of posterior malleolar fracture on CT mages.Clinical and imaging data were collected.Data on fracture location,length,and morphology were measured using X-ray films and CT images.Multivariate logistic regression a-nalysis was used to identify independent risk factors for tibial shaft fractures combined with posterior malleolar fractures,and a predic-tion model was constructed.The predictive results of the diagnostic factors was analyzed using the receiver operating characteristic curve(ROC).Results Tibial fracture location(OR=0.913,P=0.001),tibial fracture length(OR=1.154,P<0.001),and spiral tibial fracture(OR=10.202,P=0.002)were independent risk factors for tibial shaft fractures combined with posterior malleolar fractures.A prediction model was established,expressed as logit(P)=-0.091×tibial fracture location+0.143×tibial fracture length+2.323×spi-ral tibial fracture(yes=1,no=0)-1.193.The ROC curve analysis showed that the prediction model had a higher AUC than each in-dividual factor including tibial fracture location,tibial fracture length,and spiral tibial fracture.Conclusions The prediction model constructed based on tibial fracture location,length,and spiral tibial fracture demonstrates high predictive value for tibial shaft frac-tures combined with posterior malleolar fractures.