影响老年股骨髁间C型骨折手术疗效的多因素分析  

Multifactor analysis affecting surgical treatment of elderly patients femoral intercondylar type C fracture

作　　者：黄文良[1] 徐林[1] 莫刚[1] 田仁元[1] 阮世强[1] 邓江[1] HUANG Wen - liang XU Lin MO Gang et al(The Third Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, Chin)

机构地区：[1]遵义医学院第三附属医院,贵州遵义563002

出　　处：《中国伤残医学》2017年第18期6-9,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：分析影响老年股骨髁间C型骨折行钢板螺钉内固定术后疗效的相关因素.方法：回顾分析2011年3月-2016年3月期间收治的78例股骨髁间骨折老年患者,均采用切开复位钢板螺钉内固定术治疗,对年龄、性别、致伤原因、骨折分型、骨质疏松、术前ISS评分、手术入路、手术时机、复位质量、手术时间、术后CPM机功能锻炼的时间、术后并发症共12个因素先进行单因素分析,再进行多因素logistic回归分析.结果：78例患者均获得随访,时间11-28个月（平均18个月）,根据Merchan标准评定膝关节疗效,其中优28例,良24例,可11例,差5例,优良率为66.67%.单因素相关分析显示：骨折分型、骨质疏松、术前ISS 评分、手术时机、复位质量、术后开始CPM机功能锻炼的时间、术后并发症与术后膝关节功能相关;多因素Logistic回归分析显示：骨折分型、骨质疏松程度、ISS评分、复位质量、术后CPM机功能锻炼的时间为主要影响因素.结论：老年股骨髁间骨折手术复杂,影响术后膝关节关节功能的因素较多;解剖复位,坚强固定,早期活动,有利于术后膝关节功能恢复.Objective： To analyze affecting the surgical treatment of elderly patients femoral intercondylar type C fracture with plate and screw internal fixation. Methods： A total of 78 patients with femoral intercondylax fractures were treated by open reduction, plate and screw internal fixation between March 2011 and March 2016 in our hospital. Their age, gender, fracture reason, classification of fracture, ostecporosis, ISS score, operative approach, opportunity for surgical treatment, outcome of reduction, operation time, postoperative CPM motor exercise time and postoperative complications a total of 12 factors were first single factor analysis, and then multivariate logistic regression analysis. Results： All 78 patients had a followed -up in 11 -28 months （mean, 18 months）. According to the Merchant knee function scoring system, the results were excellent in 28 cases,good in 24 cases,fair in 11 cases,and poor in 5 cases with an excellent and good results rate of 66.67%. Single factor analysis showed that the classification of fracture, osteoporosis, ISS score, opportunity for surgical treatment, outcome of reduction, postoperative CPM motor exercise time and postoperative complications were prognostic factors. Logistic regression analysis showed that the classification of fracture, osteoporosis, ISS score, outcome of reduction, postoperative CPM motor exercise time and postoperative complications were major factors in the recovery of knee function. Conclusion： The operations of elderly femoral intercondylar fractures were complicated, and there were more factors affecting the knee joint function. Anatomical reduction of fractures, firm fixation and early postoperative active contributed to the restoration of postoperative knee function.

关 键 词：膝关节 股骨髁间骨折 功能恢复 相关因素 

分 类 号：R683.42[医药卫生—骨科学]