桡骨远端骨折手法复位小夹板固定后轴向再短缩移位相关因素分析  

Axial re-displacement in distal radius fracture treated by manual reduction plus plintlet external fixation

作　　者：李育敏 李世梁 孙海东 李悫 钟锐 武宁 LI Yumin;LI Shiliang;SUN Haidong;LI Que;ZHONG Rui;WU Ning(Ganzhou Hospital of Traditional Chinese Medicine,Ganzhou 341000,China)

机构地区：[1]赣州市中医院

出　　处：《临床医药实践》2020年第2期102-106,共5页Proceeding of Clinical Medicine

基　　金：江西省卫生计生委中医药科研课题（项目编号：2018A239）

摘　　要：目的:分析手法复位小夹板外固定治疗桡骨远端骨折后桡骨轴向再短缩移位的相关因素。方法:回顾性分析2016年9月—2017年9月手法复位小夹板固定治疗后桡骨轴向再短缩移位患者45例。依据复位后3个月末次随访时桡骨远端再短缩移位程度分为2组。收集其性别、年龄、患侧、骨密度、受伤至复位时间、骨折类型及固定时间等资料并比较,采用逻辑回归分析桡骨轴向再短缩移位的危险因素。结果:所有病例均获得随访,随访时间为3~4个月。两组性别、受伤至复位时间、患侧以及固定时间对轴向再短缩移位的影响比较,差异无统计学意义(P>0.05);年龄、骨折分型以及骨密度比较,差异具有统计学意义(P<0.05)。多因素逻辑回归分析显示:年龄[OR=1.514(1.012;2.091),P<0.001]、骨折分型(B,C型相对于A型)[OR=0.374(0.184;0.912),P=0.013]以及骨密度(骨质疏松)[OR=0.756(0.456;1.321),P=0.032]是桡骨远端骨折手法复位小夹板固定治疗后轴向再短缩移位的危险因素。结论:桡骨远端骨折手法复位小夹板外固定治疗抗轴向应力较弱,存在桡骨轴向再短缩移位现象,年龄、骨折分型(B,C型)和骨密度(骨质疏松)是其危险因素。Objective:To explore the relative factors of axial re-displacement of radius in distal radius fracture treated by manual reduction plus plintlet external fixation.Methods:A retrospective study was performed in 45 distal radius fractures which the distal radius has different degrees of axial residual displacement,treated by manual reduction plus plintlet external fixation from September 2016 to September 2017.They were divided into two groups according to the degree of the radial axial residual displacement.Variables such as sex,age,affected side,bone mineral density,time from injury to reduction,fracture classification and fixation time were collected and compared between the two groups.The risk factors were analyzed by Logistic analysis.Results:All 45 patients were followed up 3~4 months.There were significant statistical differences between the two groups in age,bone mineral density and fracture classification(P<0.05),although no statistical differences were found in sex,affected side,time from injury to reduction,and fixation time between them(P>0.05).Moreover,multivariate logistic regression analysis revealed that age[OR=1.514(1.012;2.091),P<0.001],fracture classification(type B and C vs types A)[OR=0.374(0.184;0.912),P=0.013]and bone mineral density(osteoporosis)[OR=0.756(0.456;1.321),P=0.032]were related to axial residual displacement.Conclusion:It could not provide enough resistance to axial shear of distal radius fracture treated by manual reduction plus plintlet external fixation,there is axial re-displacement of radius.Age,fracture classification(type B and C)and bone mineral density(osteoporosis)were risk factors.

关 键 词：桡骨远端骨折 再移位 危险因素 

分 类 号：R274.1[医药卫生—中医骨伤科学]