锁定接骨板治疗胫骨中下段关节外骨折术后延迟愈合的危险因素分析  

Analysis of the risk factors for delayed union of extra-articular fractures of the middle and lower third of the tibia treated by locking plate

作　　者：何炜[1] 许兆光[1] 林蔚莘[1] 何发胜[1] 张建新[1] 周毅强[1] HE Wei;XU Zhao-guang;LIN Wei-shen;HE Fa-sheng;ZHANG Jian-xin;ZHOU Yi-qiang(Deparment of Orthopaedics,Xiamen Hospital of Traditional Chinese Medicine,Xiamen361009,Fujian,China)

机构地区：[1]厦门市中医院骨科,福建厦门361009

出　　处：《中国骨伤》2024年第2期148-152,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨锁定接骨板治疗胫骨中下段关节外骨折术后延迟愈合的危险因素。方法:回顾性分析2013年1月至2018年12月手术并获得随访的135例胫骨中下段关节外骨折病例,男85例,女50例;年龄19~80岁;所有病例使用锁定接骨板进行治疗。根据骨折愈合情况分为正常愈合组、延迟愈合组。对14项可能影响骨折愈合的因素逐一进行单因素分析,再将单因素分析结果有显著性的因素进行二元Logistic回归分析,从而明确骨折延迟愈合的危险因素。结果:135例患者中共发生骨折延迟愈合13例。单因素分析显示骨折延迟愈合与年龄、是否吸烟、复位方式、是否贫血、术前准备时间相关。回归分析显示年龄[OR=0.849,95%CI(0.755,0.954),P=0.006]、是否吸烟[OR=0.020,95%CI(0.002,0.193),P=0.001]、复位方式[OR=23.924,95%CI(2.210,258.943),P=0.009]、是否贫血[OR=0.016,95%CI(0.001,0.289),P=0.005]是骨折延迟愈合的影像因素。结论:低龄、吸烟、闭合复位、贫血是锁定接骨板治疗胫骨中下段关节外骨折术后延迟愈合的危险因素。Objective To investigate the risk factors for delayed union of extra-articular fractures of the middle and lower third of the tibia treated by locking plate.Methods Total of 135 patients of extra-articular fractures of the middle and lower third of the tibia from January 2013 to December 2018 were retrospectively analyzed,including 85 males and 50 females,ranged from 19 to 80 years old.All cases were treated with locking plates.The patients were divided into union group and delayed union group according to the condition of fracture union.The risk factors of delayed healing were determined by univariate analysis of 14 factors that might affect fracture healing first,then the factors with significance were analyzed by binary Logistic regression.Results There were 13 patients of delayed union,and the rate of delayed union was 9.63%.Univariate analysis showed that delayed union was associated with age,smoking,reduction method,anemia and time of preoperative preparation.Regression analysis showed that age[OR=0.849,95%CI(0.755,0.954),P=0.006],smoking[OR=0.020,95%CI(0.002,0.193),P=0.001],reduction method[OR=23.924,95%CI(2.210,258.943),P=0.009],anemia[OR=0.016,95%CI(0.001,0.289),P=0.005]were the contributory factors for delayed union.Conclusion Young age,smoking,closed reduction and anemia are the risk factors for delayed union of extra-articular fractures of the middle and lower third of the tibia treated by locking plate.

关 键 词：胫骨骨折 骨折 内固定 骨折愈合 危险因素 

分 类 号：R683.42[医药卫生—骨科学]