Abstract：Objective: To investigate the relationship between serum high mobility group protein B1 (HMGB1) and caveolin-1 (Cav-1) levels and delayed healing after intramedullary nail fixation of femoral fractures. Methods: A total of 70 patients admitted to our hospital from January 2018 to July 2022 with delayed healing after intramedullary nail fixation of femur fractures were selected as the delayed healing group, and 70 patients with normal healing after intramedullary nail fixation of femur fractures were selected in a 1:1 ratio as the normal healing group. Clinical data of the patients were collected and serum HMGB1 and Cav-1 levels were measured by ELISA. The factors influencing delayed healing after intramedullary nail fixation of femoral fractures were analyzed by multi-factor logistic regression, and the ROC curve was used to analyze the predictive value of serum HMGB1 and Cav-1 levels on delayed healing after intramedullary nail fixation of femoral fractures. Results: Serum HMGB1 (2.71±0.42 ng/ml vs 3.68±1.04 ng/ml) and Cav-1 (10.85±1.89 ng/ml vs 13.03 ± 2.07 ng/ml) levels were reduced in the delayed healing group compared to the normal healing group (t=7.204, 6.497, all P<0.001). Multi-factor logistic regression analysis showed that increasing age (OR=1.095, 95% CI: 1.036 to 1.157) was an independent risk factor for delayed healing after intramedullary nail fixation of femoral fractures, and HMGB1 (OR=0.936, 95% CI: 0.904 to 0.969) and Cav-1 (OR=0.599, 95% CI: 0.470 to 0.763) were elevated as independent protective factors (all P<0.05). ROC curve analysis showed that serum HMGB1, Cav-1 levels combined predicted a greater area under the curve (AUC) for delayed healing after intramedullary nail fixation of femoral fractures than HMGB1, Cav-1 predicted individually (Z=2.352, 2.621, all P<0.05). Conclusion: Decreased serum HMGB1 and Cav-1 levels are closely associated with delayed healing after intramedullary nail fixation of femoral fractures and may be an auxiliary predictor of delayed healing after surgery.
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2023, Vol. 29 
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