累及后柱的胫骨平台骨折内固定失败的危险因素  

Risk factors related to failures of internal fixation for tibial plateau fractures involving posterior column

作　　者：邬黎平[1] 黄远翘[1] 陈元庄[1] 李宝丰[2] 张宇[3] 朱小华[4] 马滚韶[1] 莫华贵[1] 

机构地区：[1]江门市中心医院四肢关节骨科,广东529030 [2]广州军区广州总医院骨科医院 [3]广东省第二中医院骨三科 [4]中山市小榄人民医院骨科

出　　处：《中国骨与关节损伤杂志》2016年第6期610-612,共3页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金项目(81000819);广东省科技计划项目(2014A0202127000);广东省江门市科技计划项目(2014-005)

摘　　要：目的探讨累及后柱的胫骨平台骨折内固定失败的危险因素。方法自2010-02—2013-02对356例累及后柱的胫骨平台骨折患者行内固定治疗,比较不同性别、年龄、骨折类型、骨质疏松与否、关节面塌陷程度、膝关节周围合并伤、手术时机、术中骨折复位、术中植骨、术后并发症、术后康复治疗患者内固定失败的发生情况,并统计分析其危险因素。结果 359例患者获随访18个月~3年,平均2.1年。共有内固定失败19例。骨折类型（χ~2=4.573,P=0.026）、骨质疏松（χ~2=63.256,P〈0.001）、关节面塌陷程度（χ~2=6.521,P=0.010）、膝关节周围合并伤（χ~2=7.263,P=0.009）、术中骨折复位（χ~2=72.32,P〈0.001）、术中植骨（χ~2=17.403,P〈0.001）、术后并发症（χ~2=16.572,P〈0.001）、术后康复治疗（χ~2=19.149,P〈0.001）方面差异比较有统计学意义。结论骨质疏松、术中骨折复位、术中植骨、术后并发症、术后康复治疗是累及胫骨平台后柱骨折内固定失败的独立预后因素。Objective To investigate the risk factors related to failure of internal fixation for posterior column of tibial plateau fractures. Methods A retrospective research was done on 356 cases of tibia] plateau fractures involving posterior column after internal fixation from Feb. 2010 to Feb. 2013. The failure ratio of patients related to sex, age, fracture pattern, osteoporosis, the degree of joint surface subsidence, associated injury, the operative opportunity, operation reduction, bone grafting, postoperative complication and postoperative rehabilitation were calculated and compared. And the＇ risk factors of failure of internal fixation were statistically analyzed. Results There were 19 cases of internal fixation failure in 356 eases after 18 to 36 months follow-up （average 2.1 years）. There were statistically significant differences in those risk factors, which including fracture pattern（X2=4.573, P =0.026）,osteoporosis（x2 =63.256, P 〈0.001 ）,the degree of joint surface subsidence （X2- =6.521, P =0.010）, associated injury （Xz =7.263, P =0.009）, operation reduction （X2=72.32, P 〈0.001）, bone grafting （X2= 17.403, P 〈0.001）, postoperative complication （X2 =16.572, P 〈0.001） and postoperative rehabilitation （X2 =19.149, P 〈0.001）. Conclusion Osteoporosis, operation reduction, bone grafting, postoperative complication and postoperative rehabilitation are the independent risk factors of failure of internal fixation for tibia] plateau fractures involving posterior column.

关 键 词：胫骨平台骨折 内固定失败 危险因素 

分 类 号：R687.3[医药卫生—骨科学]