老年桡骨远端骨折小夹板治疗后早期腕关节功能恢复的相关因素分析  

Analysis of factors associated with early recovery of wrist function after small splint treatment of distal radius fractures in the elderly

作　　者：鲁宁[1] 魏立友[2] 李亮[3] 张玉龙 Lu Ning;Wei Liyou;Li Liang;Zhang Yulong(Department of Reception Room,Tangshan Second Hospital,Tangshan 063000,China;Department of Emergency,Tangshan Second Hospital,Tangshan 063000,China;Department of Joint,Tangshan Second Hospital,Tangshan 063000,China;Department of Trauma,Tangshan Second Hospital,Tangshan 063000,China)

机构地区：[1]唐山市第二医院接诊室,063000 [2]唐山市第二医院急诊科,063000 [3]唐山市第二医院关节科,063000 [4]唐山市第二医院创伤科,063000

出　　处：《中华老年骨科与康复电子杂志》2024年第4期222-228,共7页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：中国民族医药学会科研项目(编号:2019KYXM-Z199-35)。

摘　　要：目的分析老年桡骨远端骨折小夹板治疗后早期腕关节功能恢复的相关因素。方法回顾性分析2020年1月至2023年1月于河北省唐山市第二医院收治的515例均行小夹板治疗的老年桡骨远端骨折患者临床资料,男286例,女229例,平均年龄(75.82±7.64)岁。根据腕关节恢复情况分为恢复良好组(n=350)、恢复不良组(n=165),随访并比较两组患者一般资料(年龄、性别、体质量指数、优势手、骨质疏松、高血压、糖尿病、高脂血症)、临床资料(粉碎性骨折、掌倾角背伸、短缩畸形、骨折类型、肿胀、僵硬)及治疗相关指标(夹板固定时间、功能锻炼、畸形愈合)、腕关节功能评估量表(Gartland-Werley评分、Cooney评分),采用多因素Logistic回归分析老年桡骨远端骨折小夹板治疗后腕关节功能恢复情况的影响因素。结果515例患者均获得完整随访,随访率100.00%,随访时间6个月~10个月。恢复不良组患者年龄≥75岁、骨质疏松占比明显高于恢复良好组(P<0.05)。恢复不良组患者粉碎性骨折、短缩畸形>5mm、骨折类型CooneyⅢⅣ占比明显高于恢复良好组(P<0.05)。恢复不良组患者夹板固定时间5周、无功能锻炼、畸形愈合占比明显高于恢复良好组(P<0.05)。恢复不良组患者Gartland-Werley评分[(12.36±2.07)分]明显高于恢复良好组[(4.52±1.39)分],Cooney评分[(78.72±4.16)分]明显低于恢复良好组[(90.26±3.45)分,(t=50.673、33.100,P<0.05)]。将单因素分析中差异具有统计学意义的因素进行赋值,同时进行多因素Logistic回归分析显示,年龄≥75岁(OR=7.471)、骨质疏松(OR=5.853)、粉碎性骨折(OR=3.785)、短缩畸形>5mm(OR=6.841)、骨折类型CooneyⅢ(OR=3.904)、Ⅳ(OR=3.904)、夹板固定时间5周(OR=3.540)、无功能锻炼(OR=4.845)、畸形愈合(OR=6.366)、Gartland-Werley评分(OR=5.034)是腕关节功能恢复不良的危险因素,Cooney评分(OR=6.354)是腕关节功能恢复不良的保护因素(P<0.05)�Objective Analyze the related factors of early wrist joint function recovery after small splint treatment for elderly distal radius fractures.Methods A retrospective analysis was conducted on the clinical data of 515 elderly patients with distal radius fractures treated with mini splints at Tangshan Second Hospital in Hebei Province from January 2020 to January 2023.There were 286 males and 229 females with an average age of(75.82±7.64)years.According to the recovery of wrist joint,the patients were divided into good recovery group(n=350)and poor recovery group(n=165).The general data(age,gender,body mass index,dominant hand,osteoporosis,hypertension,diabetes,hyperlipidemia),clinical data(comminuted frac-ture,palmar inclination back extension,shortening deformity,fracture type,swelling,stiffness),treatment related indicators(splint fixation time,functional exercise,malunion),wrist joint function evaluation scale(Gartland Werley score,Cooney score)of the two groups were followed up and compared.Multifactor lo-gistic regression was used to analyze the influencing factors of wrist joint function recovery after the treat-ment of small splint for distal radius fracture in the elderly.Results All 515 patients were fully followed up,with a follow-up rate of 100.00%and a follow-up period of 6 to 10 months.The proportion of patients aged≥75 years and with osteoporosis in the group with poor recovery was significantly higher than that in the group with good recovery(P<0.05).The proportion of patients with comminuted fractures,shortening deformities greater than 5 mm,and fracture types CooneyⅢ-Ⅳin the group with poor recovery was signifi-cantly higher than that in the group with good recovery(P<0.05).The proportion of patients in the poor re-covery group who had a fixation time of 5 weeks,no functional exercise,and abnormal healing was signifi-cantly higher than that in the good recovery group(P<0.05).The Gartland Welley score(12.36±2.07 points)of patients with poor recovery was significantly higher than that of pat

关 键 词：老年人 桡骨远端骨折小夹板 早期腕关节功能恢复 因素 

分 类 号：R687.3[医药卫生—骨科学]