Construction and Evaluation of a Predictive Model for Postoperative Hip Functional Recovery in Patients with Unstable Femoral Intertrochanteric Fractures Treated with Proximal Femoral Intramedullary Nail
HAN Shuangyang
ZHAO Liben
LU Quanxiu
Abstract：Objective To construct a predictive model for postoperative hip functional recovery in patients with unsta-ble femoral intertrochanteric fractures treated with proximal femoral intramedullary nail,and to validate it.Methods A total of 361 patients with unstable femoral intertrochanteric fractures who underwent proximal femoral intramedullary nail treatment from January 2023 to February 2024 were selected.Among them,3 patients were lost to follow-up,6 patients were non-compliant in the questionnaire survey,and 352 patients were ultimately included.Patients were assigned to two groups based on their postoperative rehabilitation status:the good recovery group(n=276)and the poor recovery group(n=76).Multiva-riate Logistic regression analysis was used to identify the factors influencing poor hip functional recovery in patients.A nomo-gram prediction model was constructed and evaluated.Results Age,osteoporosis,American Society of Anesthesiologists classification,delayed weight-bearing,phobia of movement,postoperative complications,low levels of vascular endothelial growth factor,and low levels of platelet-derived growth factor were risk factors for poor hip functional recovery in patients with unstable femoral intertrochanteric fractures treated with proximal femoral intramedullary nail.Emergency surgery within 24 h,compliance with functional exercise,and self-efficacy were protective factors(P＜0.05,P＜0.01).Based on this,a nomo-gram model was constructed to predict poor postoperative hip functional recovery in patients.The validation results showed that the model had high accuracy,good predictive performance,and clinical utility.Conclusion There are numerous factors that influence the postoperative hip functional recovery of patients with unstable femoral intertrochanteric fractures.Based on this,the nomogram model constructed exhibits high accuracy,excellent predictive value,and clinical utility.
Keywords：Unstable femoral intertrochanteric fractureIntramedullary nailRehabilitationRisk factorsNomo-gramPredictive model
Publication Date：2025-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 59-65,72 )