钢板内固定治疗胫骨平台骨折继发膝创伤性关节炎的危险因素分析  

Risk Factors of Traumatic Knee Arthritis Secondary to Tibial Plateau Fracture after Nickelclad Internal Fixation

作　　者：王臻[1] 纪斌[1] 庞金辉[1] WANG Zhen JI Bin PANG Jinhui.(Department of Osteology, Putuo Hosptial Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, Chin)

机构地区：[1]上海中医药大学附属普陀医院骨科,上海200000

出　　处：《医学综述》2017年第8期1656-1658,共3页Medical Recapitulate

摘　　要：目的探究钢板内固定治疗胫骨平台骨折继发膝创伤性关节炎的危险因素。方法选择2011年1月至2012年12月在上海市普陀区中心医院骨科接受钢板内固定术治疗的178例胫骨平台骨折患者为研究对象,依据是否出现关节炎将患者分为关节炎组(34例)和非关节炎组(144例),应用单因素和多因素Logistic回归分析造成钢板内固定术后出现继发膝创伤性关节炎的危险因素。结果 Logistic回归性分析结果显示,存在骨质疏松、骨折分型级别高、高能量致伤是影响钢板内固定术后继发膝创伤性关节炎的危险因素(P<0.05),受伤至手术时间≤7 d是影响钢板内固定术后继发膝创伤性关节炎的保护因素(P<0.05)。结论钢板内固定术治疗后存在骨质疏松、骨折类型为Ⅲ、Ⅳ型以及高能量致伤的胫骨平台骨患者术后易发生创伤性关节炎,对于有此类危险的患者需要加以重视,而受伤至手术时间≤7 d影响钢板内固定术后继发膝创伤性关节炎的保护因素。Objective To explore the risk factors of traumatic knee arthritis secondary to tibial plateau fracture after nickelclad internal fixation. Methods A total of 178 cases of fracture of tibial plateau treated in the department of orthopedics of Shanghai Putuo Hospital from Jan. 2011 to Dec. 2012 were included in the study, and divided into an arthritis group （34 cases） and a non-arthritis group （144 cases）, and univariate analysis and multivariate Logistic regression analysis were used for analyzing the risk factors of secondary traumatic arthritis. Results Logistic regression analysis showed that osteoporosis,fraeture type Ⅲ-Ⅳ ,and high energy injury were the risk factors of knee arthritis secondary to trauma after internal fixation （ P 〈 0. 05 ）, time from injury to operation ≤7 d after internal fixation of knee arthritis secondary to trauma was the protection factor（ P 〈 0. 05 ）. Conclusion Patients receiving nickelclad internal fixation treatment for tibial plateau fracture with osteoporosis ,fracture type Ⅲ-Ⅳ and high energy injury are prone to traumatic arthritis ,which calls for due attention, but time from injury to operation ≤7 d is the protection factor of knee arthritis secondary to trauma after internal fixation.

关 键 词：胫骨平台骨折 创伤性关节炎 钢板内固定 危险因素 

分 类 号：R683.42[医药卫生—骨科学]