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ORIGINAL RESEARCH article

Front. Surg.
Sec. Orthopedic Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1401087

Development and validation of a nomogram for predicting the risk of postoperative fracture blister after Pilon fracture

Provisionally accepted
Pei yuan Wang Pei yuan Wang Chengsi Li Chengsi Li Lin Liu Lin Liu Zihang Zhao Zihang Zhao Zhiang Zhang Zhiang Zhang Kuo Zhao Kuo Zhao Wei Chen Wei Chen Yingze Zhang Yingze Zhang Lin Jin Lin Jin *Zhiyong Hou Zhiyong Hou *
  • Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China

The final, formatted version of the article will be published soon.

    Background Fracture blister (FB) is one of the most common complications in pilon fractures. This study aimed to construct and validate a nomogram for predicting postoperative FB risk in patients with pilon fractures.Methods Patients with FBs were considered as the FB group and those without FB as the non-FB group.Variables with a significance level of P < 0.05 in the univariate analysis were included in the multivariate logistic regression analysis. The backward stepwise regression method was applied to identify independent risk factors associated with FB. The selected predictors were then entered into R software for further analysis and Nomogram construction.In our research, the rate of FB (119 of 1119) was 10.63%. Several predictors of FB were found using univariate analysis, including body mass index (BMI) (p＜0.001), the presence of DVT(p ＜ 0.001), closed fractures (p ＜ 0.001), time from injury to admission (p<0.001), smoking history (p<0.01), not utilizing dehydrating agents (p<0.010), fixation mode of fracture (p＜0.001), the mode of surgical suture (p＜0.001), postoperative infection (p＜0.001) and Elixhauser comorbidity index (ECI) (p<0.01). In addition, FB group exhibited significantly higher levels of blood serum indicators,. According to the stepwise logistic regression analysis, higher BMI (p = 0.011, OR 0.873, 95% CI 0.785 to 0.970), NEU (p = 0.036, OR 0.982, 95% CI 0.865 to 0.995) and CKMB (p < 0.014, OR 0.994, 95% CI 0.989 to 0.999) were associated with increased FB risk, while plate fixation (p = 0.017, OR 0.371, 95% CI 0.123 to 0.817), the mode of surgical suture (p < 0.01, OR 0.348, 95% CI 0.161 to 0.749), and postoperative infection (p=0.020, OR 0.406, 95% CI 0.190 to 0.866) were also correlated with increased FB risk. Conclusions Our investigation has shown that BMI, NEU, CKMB, plate fixation, the mode of surgical suture, and postoperative infection are independent risk factors for FB in patients with pilon fractures.

    Keywords: Fracture blister, Pilon fractures, Postoperation, Body Mass Index, Neutrophil, Creatine Kinase (MB Form), plate fixation, The mode of surgical suture

    Received: 14 Mar 2024; Accepted: 18 Sep 2024.

    Copyright: © 2024 Wang, Li, Liu, Zhao, Zhang, Zhao, Chen, Zhang, Jin and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Lin Jin, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei Province, China
    Zhiyong Hou, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei Province, China

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