New AI Model Predicts Chronic Pain Risk After Calcaneal Fracture Surgery, finds study
A new study published in BMC Musculoskeletal Disorders found that chronic pain after calcaneal fracture surgery contributes significantly to quality of life deterioration in patients. After examining data in individuals who underwent surgical intervention the study elucidated independent predictors and evaluated reliability of the model. This study was conducted by Shibo Z. and fellow researchers.
Retrospective analysis involved 398 patients who were operated on for calcaneal fractures. The patients were divided into two groups randomly: 280 in the model development cohort and 118 in the validation cohort. Multivariate logistic regression was used to determine independent risk factors for chronic pain. Accuracy of the model was determined using the area under the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis.
Key Findings
Many predictive variables such as those linked to increase lifetime risk of chronic pain include the following:
Body Mass Index (BMI): Higher BMI was associated with an increased risk (OR: 1.10, 95% CI: 1.02–1.19, P=0.014).
Operative Duration: Longer surgical time increased the likelihood of chronic pain (OR: 1.01, 95% CI: 1.00–1.02, P=0.019).
Surgical Approach: The type of surgical technique used influenced postoperative pain outcomes.
Böhler Angle: Higher Böhler angles were linked to a higher risk (OR: 1.03, 95% CI: 1.00–1.06, P=0.025).
The predictive model demonstrated good discrimination in both the development cohort (AUC: 0.691, 95% CI: 0.63–0.75) and the validation cohort (AUC: 0.655, 95% CI: 0.56–0.77). Calibration plots confirmed strong agreement between predicted and observed outcomes.
The study authors concluded that the predictive model is a valid medium for chronic pain risk assessment after calcaneal fracture surgery. It provides the practitioner with an individualized assessment of the patient while including significant risk factors whereby more targeted interventions for recovery and quality of life are possible.
Reference:
Zhai, S., Zhang, S., Ma, X. et al. Development of a predictive model for post-surgical chronic pain: a retrospective analysis of calcaneal fracture patients. BMC Musculoskelet Disord 26, 173 (2025). https://doi.org/10.1186/s12891-025-08428-y
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