桡骨远端骨折术后腕关节功能恢复不佳的高危因素  

High risk factors for poor recovery of postoperative wrist function in patients with distal radius fractures

作　　者：卢博 杨波 霍乐乐 LU Bo;YANG Bo;HUO Lele(The Orthopedics Hospital of Henan Province,Zhengzhou,Henan,450000,China)

机构地区：[1]河南省洛阳正骨医院河南省骨科医院骨与关节感染科,河南郑州450000

出　　处：《实用手外科杂志》2022年第4期509-511,517,共4页Journal of Practical Hand Surgery

摘　　要：目的探析桡骨远端骨折术后腕关节功能恢复不佳的高危因素。方法选取2019年1月-2021年10月收治的桡骨远端骨折患者62例作为研究对象,所有患者于术后6个月采用Gartland Werley腕关节评分评估腕关节恢复情况并进行分组,设计基线资料调查表,记录研究所需资料,采用Logistic回归分析桡骨远端骨折患者术后腕关节功能恢复不佳的高危因素。结果术后6个月随访结果,62例中术后腕关节功能恢复不佳13例,占比20.97%;恢复不佳组骨折类型、骨质疏松、伴月骨凹塌陷与恢复良好组比较,差异有统计学意义(P<0.05);恢复不佳组外固定架固定时间长于恢复良好组,差异有统计学意义(P<0.05);建立Logistic回归分析模型,开放性骨折、外固定架固定时间长、骨质疏松以及伴月骨凹塌陷是桡骨远端骨折术后腕关节功能恢复不佳的高危因素(OR>1,P<0.05)。结论开放性骨折、外固定架固定时间长、骨质疏松以及伴月骨凹塌陷是桡骨远端骨折术后腕关节功能恢复不佳的高危因素。因此,术前做好保守治疗,稳定患者临床症状,并制定针对性手术方案,术后缩短外固定架固定时间,加强骨营养,控制骨质疏松的发展,可有效促进腕关节功能的恢复。Objective To explore the high risk factors for poor recovery of postoperative wrist function in patients with distal radius fracture.Methods Sixty-two patients with distal radius fractures admitted to the hospital from January 2019 to October 2021 were selected as the research subjects.All patients were assessed with Gartland Werley wrist score 6 months after operation.The patients were divided into groups according to the recovery of wrist joint.The baseline data questionnaire was designed to record the data required for the study.Logistic regression was used to analyze the high risk factors for poor recovery of postoperative wrist function in patients with distal radius fracture.Results Follow-up results at 6 months after operation showed that 13 of 62 patients with distal radius fracture had poor recovery of wrist function after operation,accounting for 20.97%;compared fracture type,osteoporosis,associated lunate concave collapse between the poorly recovered group and the well recovered group,the difference was statistically significant(P<0.05);the fixation time of external fixator in poor recovery group was longer than that in good recovery group,the difference was statistically significant(P<0.05);Logistic regression analysis model was established,open fracture,long time of external fixation,osteoporosis and collapse of lunate fossa were high risk factors for poor recovery of postoperative wrist function in patients with distal radius fracture(OR>1,P<0.05).Conclusion Open fracture,long external fixation time,osteoporosis and associated lunate fossa collapse are high risk factors for poor recovery of postoperative wrist function in patients with distal radius fracture.

关 键 词：桡骨远端骨折 腕关节 骨质疏松 外固定架 克氏针固定术 

分 类 号：R687.3[医药卫生—骨科学]