Objective To study the predictive factors of patients with metacarpal basal extra articular fractures.
Methods The clinical data of 102 patients with extra-articular metacarpal fractures treated was retrospectively analyzed. They were divided into good healing group (n=55) and poor healing group (n=47) according to their postoperative bone healing. The basic dataage, gender, fixation type of surgery, fracture causes, postoperative infection, fracture classification, fracture types, bone morphogenetic protein (BMP), bone growth factor (SGF), and platelet-derived growth factor (PDGF) of the two groups were compared, and Receiver Operating Characteristic (ROC) curve was used to analyze the area under the curve, sensitivity and specificity of BMP, SGF and PDGF levels in predicting poor bone healing after metacarpal extra-articular fracture surgery. Finally, Logistic regression analysis model was used to identify the risk factors of poor bone healing after metacarpal extra-articular fracture surgery.
Results The ratios of patients with postoperative infection, open fracture and comminuted fracture in the poor healing group were significantly higher than those in the good healing group (P < 0.05); BMP, SGF and PDGF levels in the poor healing group were significantly lower than those in the good healing group (P < 0.05). ROC analysis results showed that the areas under the curve of BMP, SGF and PDGF were 0.618, 0.644 and 0.737, respectively. Multivariate Logistic regression analysis showed that postoperative infection, open fracture, comminuted fracture, BMP < 7.415 pg/mL, SGF < 85.705 ng/mL and PDGF < 5.235 ng/mL were the risk factors of poor bone union (P < 0.05).
Conclusion Postoperative infection, open fracture, comminuted fracture and other clinical features, as well as BMP < 7.415 pg/mL, SGF < 85.705 ng/mL and PDGF < 5.235 ng/mL all lead to the poor bone healing in patients with extra-articular fractures.
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