膝关节周围骨折内固定术后并发创伤性关节炎的因素分析:基于PSM法  

Analysis of factors for traumatic arthritis after internal fixation of knee joint fractures:based on PSM method

作　　者：卢家宁 贾金领[1] Lu Jianing;Jia Jinling(Department of Orthopedic SurgeryⅡ,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China.)

机构地区：[1]新乡医学院第一附属医院骨外科二病区,河南新乡453100

出　　处：《齐齐哈尔医学院学报》2024年第22期2156-2161,共6页Journal of Qiqihar Medical University

摘　　要：目的基于倾向性评分匹配法(PSM)分析膝关节周围骨折内固定术后并发创伤性关节炎的影响因素。方法回顾性分析2019年1月—2022年1月本院收治的431例膝关节周围骨折内固定术患者临床资料,根据术后是否并发创伤性关节炎分为发生组(n=69)和未发生组(n=362)两组,比较两组患者一般资料;基于PSM匹配两组一般资料,比较匹配后发生组(n=67)和未发生组(n=67)一般资料,并对其术后并发创伤性关节炎的影响因素进行Logistic回归分析。结果膝关节周围骨折患者内固定术后创伤性关节炎发生率为16.01%(69/431);匹配前两组患者在体质量指数(BMI)、致伤方式、骨折分型、合并糖尿病、骨质疏松症、半月板损伤、受伤至手术时间、机械轴对线偏移程度、术中解剖复位方面存在比差异具有统计学意义(P<0.05),匹配后除致伤方式外其余指标比较差异有统计学意义(P<0.05);BMI(OR=1.565,95%CI:1.070~2.289)、骨折分型(OR=1.669,95%CI:1.179~2.361)、合并糖尿病(OR=1.619,95%CI:1.167~0.246)、骨质疏松症(OR=1.645,95%CI:1.168~2.319)、半月板损伤(OR=1.657,95%CI:1.190~2.308)、受伤至手术时间(OR=1.706,95%CI:1.194~2.437)、机械轴对线偏移程度(OR=1.687,95%CI:1.195~2.382)、术中骨折非解剖复位(OR=2.012,95%CI:1.305~3.102)是创伤性关节炎的影响因素(P<0.05)。结论BMI、骨折分型、合并糖尿病、骨质疏松症、半月板损伤、受伤至手术时间、机械轴对线偏移程度、术中解剖复位是创伤性关节炎的影响因素。Objective To analyze the influencing factors of traumatic arthritis following internal fixation surgery for fractures around the knee joint using propensity score matching(PSM).Methods A retrospective analysis was conducted on the clinical data of 431 patients who underwent internal fixation surgery for fractures around the knee joint from January 2019 to January 2022.Patients were divided into two groups based on the occurrence of postoperative traumatic arthritis:the arthritis group(n=69)and the non-arthritis group(n=362).General information was compared between the two groups.After matching with PSM,the general information of the matched arthritis group(n=67)and non-arthritis group(n=67)was compared,and the influencing factors of postoperative traumatic arthritis were analyzed using Logistic regression.Results The incidence of traumatic arthritis after internal fixation for fractures around the knee joint was 16.01%(69/431).Significant differences in body mass index(BMI),injury mechanism,fracture classification,comorbid diabetes,osteoporosis,meniscal injury,time from injury to surgery,mechanical axis deviation,and intraoperative anatomical reduction were observed between the two groups before matching(P<0.05).After matching,all factors except the injury mechanism showed significant differences(P<0.05).BMI(OR=1.565,95%CI:1.070~2.289),fracture classification(OR=1.669,95%CI:1.179~2.361),comorbid diabetes(OR=1.619,95%CI:1.167~0.246),osteoporosis(OR=1.645,95%CI:1.168~2.319),meniscal injury(OR=1.657,95%CI:1.190~2.308),time from injury to surgery(OR=1.706,95%CI:1.194~2.437),mechanical axis deviation(OR=1.687,95%CI:1.195~2.382),and non-anatomical reduction during surgery(OR=2.012,95%CI:1.305~3.102)were identified as influencing factors for traumatic arthritis(P<0.05).Conclusions BMI,fracture classification,comorbid diabetes,osteoporosis,meniscal injury,time from injury to surgery,mechanical axis deviation,and non-anatomical reduction during surgery are influencing factors for traumatic arthritis.

关 键 词：倾向性评分匹配法 膝关节周围骨折 内固定 创伤性关节炎 影响因素 

分 类 号：R619.5[医药卫生—外科学]