The Relationship Between Serum tPⅠNP and N-MID Levels and Postoperative Joint Dysfunction after Elbow Fracture Surgery
FENG Bolin
LIANG Zhenming
YANG Shukai
LI Jiawei
ZHAO Zhibin
Abstract：Objective To explore the relationship between serum levels of total procollagen typeⅠN-terminal propeptide(tPⅠNP)and N-terminal mid-fragment of osteocalcin(N-MID)and postoperative joint dysfunction after elbow fracture surgery.Methods A total of 156 patients with elbow fractures who underwent surgical treatment at the Affiliated Hospital of Guangdong Medical University from January 2019 to May 2024 were retrospectively selected.They were divided into the dysfunction group(42 cases)and the normal function group(114 cases)based on the presence of joint dysfunction at 6 months after surgery.The general clinical data of the two groups were compared;Pearson correlation analysis was used to analyze the relationship between serum tPⅠNP and N-MID levels and the Mayo elbow performance score;Multivariate Logistic stepwise regression analysis was used to identify the influencing factors for postoperative joint dysfunction after elbow fracture;and receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of the influencing factors for postoperative joint dysfunction after elbow fracture.Results The dysfunction group had higher age,a higher proportion of patients with time from fracture to surgery≥7 days,a higher proportion of patients with time to initiation of functional exercise after surgery≥30 days,and a higher proportion of patients with postoperative complications compared to the normal function group(all P<0.05).The serum levels of tPⅠNP and N-MID in the dysfunction group were significantly lower than those in the normal function group(both P<0.001).Pearson correlation analysis showed that serum tPⅠNP and N-MID levels were positively correlated with the Mayo elbow performance score(r=0.502,0.497,respectively;both P<0.001).Multivariate Logistic stepwise regression analysis showed that tPⅠNP≤58.12 ng/mL and N-MID≤19.30 ng/mL were independent risk factors for joint dysfunction after elbow fracture surgery(OR=2.992,95%CI:1.756-5.099,P<0.001;OR=3.165,95%CI:1.727-5.799,P<0.001).ROC curve analysis showed that the area under the curve(AUC)for the combined(parallel)prediction of postoperative joint dysfunction after elbow fracture using serum tPⅠNP and N-MID was 0.908,which was significantly superior to the AUC for serum tPⅠNP alone(0.776)and N-MID alone(0.825)(Z=10.605,9.811,respectively;both P<0.001).Conclusion Decreased serum levels of tPⅠNP and N-MID are closely related to postoperative joint dysfunction after elbow fracture surgery,and the combined detection of both has high predictive value for postoperative joint dysfunction.
Keywords：total procollagen type I N-terminal propeptideN-terminal mid-fragment of osteocalcinelbow fractureopen reduction and internal fixationjoint dysfunction
Publication Date：2025-12-20
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：5( 26-30 )