距骨骨折手术治疗效果的影响因素分析  

Analysis of the efficacy-related factors of the talus fracture operation

作　　者：来津[1] 谭俊铭[1] 申练兵[1] 邢顺民[1] 何翔[1] 王金鑫[1] 张颉锋[1] 

机构地区：[1]中国人民解放军第九八医院骨六科,浙江省湖州313300

出　　处：《中国医师杂志》2013年第12期1658-1661,共4页Journal of Chinese Physician

摘　　要：目的探讨与距骨骨折手术疗效有关的影响因素。方法选择2007年9月至2010年9月在本科行切开复位内固定手术治疗距骨骨折患者45例，男39例，女6例，年龄（33．8±10．2）岁；其中距骨体骨折27例，距骨颈骨折18例。采用美国足踝外科学会（AOFAS）的踝-后足评分系统评定手术疗效。采用Logistic回归方法分析距骨骨折部位、开放与否、骨折粉碎程度以及是否合并距骨周围骨折与手术疗效的相关性。结果随访（3．6±0．4）年，术后优良率为55．5％。不同骨折复位患者术后功能评分比较差异有统计学意义（P〈0．05）。而不同内固定方式患者术后功能恢复情况比较差异无统计学意义（P〉0．05）。Logistic回归分析显示，与术后并发症相关的影响因素为开放与否、骨折粉碎程度、骨折复位情况、骨折部位、是否合并距骨周围骨折（P〈0．05）。结论距骨骨折术后并发症较为常见。良好的复位和内固定，有助于距骨骨折术后功能的恢复，从而减少并发症。Objective To explore the influence factors of talus fracture operation curative effect. Methods Forty five patients [ average age （ 33.8 ± 10. 2） years ; male = 39, female = 6 ] were chosen from September 2007 to September 2010 in my family line open reduction and internal fixation surgery from the talus fracture patients, including 27 cases of talus body fractures and 18 cases of talus neck fractures. The operation curative effect was evaluated with the Ankle-Foot Rating System from the American Orthopaedic Foot and Ankle Society （AOFAS）. Logistic regression was used to analyze the correlation of operation curative effect with some factors including the bone fracture position, open or not, fracture degree of grinding, and no merge from the bone fracture. Results The mean follow-up was （3.6 ± 0. 4） years, the curative rate was 55.5%. The different fracture patients had significant different postoperative function evaluation score （ P 〈 0. 05 ）. Different fixation function recovery after surgery was no statistically significant difference （ P 〉 0. 05）. Logistic regression analysis showed that the postoperative complication-related influencing factors were open or not, fracture degree of grinding, the fracture reduction status, fracture position, and merger astragalus around fracture （ P 〈 0.05 ）. Conclusions The postoperative complications from the fracture of talus was more common. Good reduction and internal fixation benefits the bone fracture function recovery and reduces the complications.

关 键 词：骨折 外科学 骨折固定术 内 距骨 损伤 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]