Wang et al reported a nomogram for predicting reduction loss following licking plate fixation of a fracture of the proximal humerus. The authors are from The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University in China.
Reduction loss refers to an inability to maintain the fractured bone in reduction. This may be a reason for revision surgery over time.
Patient selection: locking plate fixation of a proximal humeral fracture
Parameters:
(1) age in years from35 to 90 years
(2) fracture type (Neer type II, III, or IV)
(3) medial comminution
(4) calcar screw
points for age =
= (1.789 * (age)) - 62.618
Parameter
Finding
Points
fracture type
II
0
III
69.1
IV
100
medial comminution
no
0
yes
19.2
calcar screw
no
0
yes
37.7
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 255.4
value of X =
= (0.08021 * (score)) - 16.71
probability of reduction loss =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.94.
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