胫骨平台伴髁间棘骨折外科修复后关节功能康复的影响因素分析  

Analysis of joint functional rehabilitation after surgical repair of tibial plateau with intercondylar eminence fractures

作　　者：薛宏伟 郑如庚 崔阳 XUE Hongwei;ZHENGRugeng;CUI Yang(Department of Orthopaedics,Baoding Second Central Hospital,Baoding,Hebei 072750,China)

机构地区：[1]保定市第二中心医院骨科,河北072750

出　　处：《中国骨与关节损伤杂志》2024年第8期820-824,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的探究胫骨平台伴髁间棘骨折患者外科修复后关节功能康复的影响因素。方法纳入自2018-05—2023-05于笔者所在医院接受外科修复治疗的100例胫骨平台伴髁间棘骨折。比较患者术前与术后3个月膝关节功能Lysholm评分、疼痛VAS评分、膝关节活动度及胫骨平台后倾角。根据患者术后3个月膝关节功能Lysholm评分进行分组,≥70分的纳入良好组(78例),<70分的纳入不良组(22例),收集两组的一般资料,并进行单因素及多因素分析,探究患者外科修复后关节功能康复的影响因素。结果所有患者均顺利完成手术并获得至少3个月的随访。术后3个月膝关节功能Lysholm评分各维度均较术前明显提高,差异有统计学意义(P<0.05)。术后3个月胫骨平台后倾角及膝关节活动度均较术前明显增大,疼痛VAS评分较术前降低,差异均有统计学意义(P<0.05)。单因素及多因素分析结果显示,年龄、体质量指数、术前ASA分级、骨质疏松、手术时间、术前膝关节活动度均会对患者术后关节功能的恢复情况产生影响(P<0.05)。结论胫骨平台伴髁间棘骨折患者外科修复后,膝关节功能得到改善,疼痛程度减轻,活动度增加,同时术后恢复情况受年龄、体质量指数、术前ASA分级、骨质疏松、手术时间、术前膝关节活动度等因素的影响,应予以密切关注。Objective To explore the factors influencing joint function recovery in patients with tibial plateau fractures accompanied by intercondylar eminence fractures after surgical repair.Methods A total of 100 patients with tibial plateau fractures accompanied by intercondylar eminence fractures who underwent surgical repair at the author's hospital from May 2018 to May 2023 were included.The Lysholm knee scoring scale,Visual Analog Scale(VAS)for pain,knee joint range of motion(ROM),and posterior tibial slope angle were compared preoperatively and 3 months postoperatively.Patients were grouped based on their Lysholm scores at 3 months postoperatively:the good outcome group(≥70 points,78 patients)and the poor outcome group(<70 points,22 patients).General data were collected for both groups,and univariate and multivariate analyses were performed to investigate the factors affecting joint function recovery after surgical repair.Results All patients successfully completed the surgery and were followed up for at least 3 months.The Lysholm scores in all dimensions significantly improved at 3 months postoperatively compared to preoperative values(P<0.05).The posterior tibial slope angle and knee ROM significantly increased,while the VAS pain score significantly decreased at 3 months postoperatively compared to preoperative values(P<0.05).Univariate and multivariate analyses showed that age,body mass index(BMI),preoperative ASA classification,osteoporosis,surgery duration,and preoperative knee ROM significantly influenced the recovery of joint function postoperatively(P<0.05).Conclusion Surgical repair of tibial plateau fractures accompanied by intercondylar eminence fractures improves knee joint function,reduces pain,and increases ROM.Postoperative recovery is influenced by factors such as age,BMI,preoperative ASA classification,osteoporosis,surgery duration,and preoperative knee ROM,which should be closely monitored.

关 键 词：胫骨平台伴髁间棘骨折 外科修复 关节功能 影响因素 

分 类 号：R687.3[医药卫生—骨科学]