创伤性桡骨远端骨折固定术后腕关节功能恢复不良的危险因素研究  

Risk Factors for Wrist Joint Recovery after Traumatic Distal Radial Fracture Fixation

作　　者：李吉利 姚恒 王炜 刘延军 李世龙 胡金杉 闫福成 吕科 LI Jili;YAO Heng;WANG Wei(Xianyang First People's Hospital, Shanxi Xianyang 712000, China)

机构地区：[1]陕西省咸阳市第一人民医院骨四科

出　　处：《河北医学》2020年第2期315-320,共6页Hebei Medicine

基　　金：陕西省精准医学重点实验室开放课题，(编号:KLTPM-SX2017-A1)

摘　　要：目的:探讨创伤性桡骨远端骨折固定术后腕关节功能恢复不良的危险因素。方法:选取我院2011年8月至2017年10月收治的创伤性桡骨远端骨折固定术患者98例,根据术后6个月腕关节功能恢复效果,将其分成良好组、不良组。比较两组临床特征:包括性别、年龄、体质指数、就诊时间、骨质疏松、骨折类型、骨折AO分型、损伤能量、尺骨茎突骨折、末次复查掌倾角、末次复查桡骨短缩、功能锻炼。采用Logistic回归模型分析创伤性桡骨远端骨折固定术后腕关节功能恢复不良的危险因素。结果:在98例患者中,有26例恢复不良,占26.53%,72例恢复良好,占73.47%。不良组年龄≥65岁、有骨质疏松、粉碎性骨折、末次复查掌倾角<10度、末次复查桡骨短缩≥5mm、功能锻炼不规律占比分别为53.85%、65.38%、57.69%、46.15%、46.15%、42.31%,高于良好组的31.94%、15.28%、16.67%、16.67%、15.28%、9.72%,差异有统计学意义(P<0.05)。Logistic回归性分析提示年龄(≥65岁)、骨质疏松、粉碎性骨折、末次复查掌倾角(掌倾<10度)、末次复查桡骨短缩(≥5mm)、功能锻炼(不规律)是患者术后腕关节恢复不良的危险因素(P<0.05)。结论:创伤性桡骨远端骨折内固定术后腕关节恢复功能不良与年龄≥65岁、骨质疏松、粉碎性骨折、掌倾角掌倾<10度、桡骨短缩≥5mm、不规律功能锻炼密切相关。Objective:To explore the risk factors of wrist joint recovery after traumatic distal radius fracture fixation.Methods:From August 2011 to October 2017,98 patients with traumatic distal radius fracture were selected and divided into good group and bad group according to the recovery effect of wrist joint 6 months after operation.The clinical characteristics of the two groups were compared,including sex,age,body mass index,time of treatment,osteoporosis,fracture type,fracture AO classification,injury energy,fracture of styloid process of ulna,last reexamination of palm angle,last reexamination of radial shortening and functional exercise.Logistic regression model was used to analyze the risk factors of poor wrist joint recovery after fixation of traumatic distal radius fracture.Results:Among the 98 patients,26 cases recovered poorly,accounting for 26.53%,72 cases recovered well,accounting for 73.47%.The proportion of irregular exercise was 53.85%,65.38%,57.69%,46.15%,46.15%and 42.31%in the poor group,which was higher than 31.94%,15.28%,16.67%,16.67%,15.28%,9.72%in the good group(P<0.05).Logistic regression analysis showed that age(>65 years),osteoporosis,comminuted fracture,palmar tilt angle at the last reexamination(<10 degrees),radial shortening(>5mm)at the last reexamination,and functional exercise(irregular)were the risk factors for poor wrist recovery(P<0.05).Conclusion:The poor recovery of wrist joint after internal fixation of traumatic distal radius fracture is closely related to age≥65 years old,osteoporosis,comminuted fracture,palm angle<10度,radius shortening≥5mm and irregular functional exercise.

关 键 词：创伤性桡骨远端骨折 腕关节恢复不良 危险因素 桡骨短缩 

分 类 号：R687.3[医药卫生—骨科学]