Analysis of risk factors for postoperative shoulder joint dysfunction in patients with surgical neck fractures of the humerus combined with rotator cuff injury
10.3760/cma.j.cn341190-20240907-01147
- VernacularTitle:肱骨外科颈骨折合并肩袖损伤患者术后并发肩关节功能障碍的危险因素分析
- Author:
Hua ZHANG
1
;
Linbing FU
1
Author Information
1. 诸暨市中心医院急诊创伤骨外科，诸暨 311800
- Publication Type:Journal Article
- Keywords:
Humeral fractures;
Shoulder joint;
Motor disorders;
Age factors;
Osteoporosis;
Risk factors;
Root cause analysis
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(9):1361-1366
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for postoperative shoulder joint dysfunction in patients with surgical neck fractures of the humerus combined with rotator cuff injury.Methods:Eighty-three patients with postoperative shoulder dysfunction with surgical neck fractures of the humerus combined with rotator cuff injury who received treatment at Zhuji Central Hospital from January 2019 to December 2022 were included in the observation group. Additionally, 80 patients with surgical neck fractures of the humerus combined with rotator cuff injury who concurrently received treatment at the same hospital but did not suffer from shoulder dysfunction after surgery were included in the control group. The general data of the two groups were analyzed. The Pearson test was used to assess the correlation between age, the presence of osteoporosis, the surgical reduction method, the Neer classification of the shoulder joint, and the occurrence of shoulder dysfunction in patients with surgical neck fractures of the humerus combined with rotator cuff injury after surgery. Multivariate logistic regression analysis was performed to analyze the risk factors for postoperative shoulder dysfunction in these patients. Results:The proportion of patients over 70 years old, the proportion of patients with osteoporosis, the proportion of patients with Neer type III fractures and above, and the proportion of patients undergoing conventional reduction in the observation group were 48.19% (40/83), 60.24% (50/83), 36.14% (30/83), and 60.24% (50/83), respectively. These proportions were significantly higher than those in the control group [18.75% (15/80), 41.25% (33/80), 18.75% (15/80), and 43.75% (35/80), χ2 = 21.37, 5.87, 7.06, 4.44, P < 0.001, 0.015, 0.029, 0.035]. Pearson's correlation test revealed that age, combined osteoporosis, fracture Neer classification, and routine reduction were positively correlated with the postoperative development of shoulder dysfunction in patients with surgical neck fractures of the humerus combined with rotator cuff injury ( r = 0.812, 0.796, 0.823, 0.814, all P < 0.05). Multivariate logistic regression analysis results showed that age, osteoporosis, fracture Neer classification, and conventional reduction were risk factors for postoperative shoulder dysfunction in these patients ( OR = 3.504, 3.823, 3.607, 4.059, all P < 0.05). Conclusions:Age, osteoporosis, fracture Neer classification, and conventional reduction are risk factors for postoperative shoulder dysfunction in patients with surgical neck fractures of the humerus combined with rotator cuff injury. A systematic preoperative evaluation and adherence to rehabilitation exercises after surgery may help reduce the incidence of shoulder joint dysfunction.
