下肢骨折锁定加压钢板内固定失败的Logistic回归分析  

Fixation failure in lower extremity fractures treated with locking compression plate

作　　者：宁鹏[1] 赵铭[1] 张月东[1] 

机构地区：[1]山东省泰安市中心医院骨二科,271000

出　　处：《中国矫形外科杂志》2014年第24期2238-2243,共6页Orthopedic Journal of China

摘　　要：[目的]探讨下肢负重骨股骨及胫腓骨骨折锁定加压钢板（locking compression plate,LCP）固定失败的主要危险因素并提出预防措施。[方法]回顾分析2006年1月-2012年11月本院收治经LCP治疗的股骨及胫腓骨骨折患者408例,其中内固定失败23例。利用SPSS 19.0软件通过单因素及多因素Logistic回归分析对8个可能影响内固定失败的因素年龄、性别、骨折类型、骨折部位、钢板长度、螺钉密度、骨折端是否存在骨缺损和开始负重时间进行分析。[结果]408例患者临床资料全部收集完整并纳入Logistic回归分析。单因素Logistic回归分析发现骨折部位、螺钉密度、骨折端是否存在骨缺损和开始负重时间4个因素与LCP内固定失败相关性有显著性意义（P≤0.05）;多因素Logistic回归分析发现螺钉密度、骨折端是否存在骨缺损和术后开始负重时间3个因素与LCP内固定失败相关性有显著性意义（P≤0.05）。[结论]螺钉密度、骨折端是否存在骨缺损和开始负重时间是导致股骨及胫腓骨骨折LCP内固定失败的主要危险因素。选择适当的LCP及螺钉,减少骨缺损及骨折端分离,避免过早负重是减少LCP内固定失败的关键。[ Objective] This study aimed to explore the main risk factors of fixation failure in the lower- extremity long- bone fractures treated with locking compression plate （LCP）. [ Method ] The clinical data of 408 patients with femoral fractures or tibiofibular fractures treated with LCP in our hospital between January 2006 and November 2012 were retrospectively studied, and fixation failure occurred in 23 cases. Statistical analysis were performed with use of SPSS 19.0 software. Single factor and multi - factor logistic regression analysis were applied to study the eight possible factors of LCP fixation failure, including age, sex, fracture type, fracture position, the length of LCP plate, plate screw density, bone defect in the fracture site and postoperative weight- bearing time. [ Result] The clinical data of 408 cases were collected and logistic regression analysis was performed. In single factor logistic regression analysis, the fracture position, plate screw density, bone defect in the fracture site and postopera- tive weight - bearing time were significantly correlated with LCP internal fixation failure （ P ≤0. 05 ）. In multi - factor logistic regression analysis,the screw density,presence of bone defect in the fracture site and postoperative weight - beating time were significantly correlated with LCP internal fixation failure （P ≤0.05 ）. [ Conclusion ] The plate screw density, presence of bone defect in the fracture site and postoperative weight - bearing time were the major risk factors leading to fixation failure in femoral or tibiofibular fracture treated with LCP. The appropriate application of LCP,the selection of the screw, bone defect and fracture separation correction and ways to avoid premature weight bearing are the key to reduce LCP fixation failure.

关 键 词：股骨骨折 胫腓骨骨折 锁定加压钢板 LOGISTIC回归分析 

分 类 号：R687.32[医药卫生—骨科学]