未成年膝关节周围骨折后功能恢复的影响因素分析  

Analysis of risk factors for postoperative functional recovery of fractures around knee joint

作　　者：郑艳[1] 彭琳瑞[1] 赵华国[1] ZHENG Yan;PENG Lin-rui;ZHAO Hua-guo(Department of Orthopaedics,Ningbo No.6 Hospital,Ningbo315040,Zhejiang,China)

机构地区：[1]宁波市第六医院骨科,浙江宁波315040

出　　处：《中国骨伤》2024年第12期1219-1223,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:通过对未成年膝关节周围骨折(fracture around knee joint,FAKJ)的危险因素进行分析,筛选影响FAKJ功能恢复的因素。方法:自2017年6月至2019年6月对364例FAKJ患者的临床资料进行分析,包括患者年龄、性别、居住环境、受伤原因、骨折类型、骨折治疗方式、制动时间、康复师指导、患者依从性等资料。进行单因素和多因素分析筛选影响FAKJ的危险因素。观察结果为随访期间内患侧肢体出现疼痛、关节活动减少或跛行之一,定义为FAKJ恢复不良。结果:364例FAKJ患者中出现恢复不良51例(14.01%),膝关节活动受限35例(9.61%),膝关节疼痛10例(2.75%),功能性跛行5例(1.37%),再骨折1例(0.27%)。单因素分析结果显示,两组患者年龄、骨折类型、制动时间、患者依从性方面差异有统计学意义(P<0.05)。多因素Logistic分析结果显示年龄≥7岁[OR=1.512,95%CI(1.019,2.118),P<0.05],胫骨近端骨折[OR=3.813,95%CI(3.189,5.334),P<0.05],制动时间≥4周[OR=1.299,95%CI(1.081,8.418),P<0.05]和依从性差[OR=1.282,95%CI(1.119,3.921),P<0.05]是影响FAKJ的危险因素(P<0.05)。结论:年龄(≥7岁)、胫骨近端骨折、制动时间≥4周和依从性差是影响患者FAKJ功能恢复的危险因素,可帮助临床医生筛选高风险患者以及制定个性化治疗方案。Objective To screen factors independently affect functional recovery of fracture around knee joint by analyzing risk factors of fracture around knee joint(FAKJ)in minors.Methods Clinical data of 364 FAKJ patients were collected from June 2017 to June 2019,and Logistic regression was performed for single-factor and multivariate analysis.Possible risk factors were included,such as age,gender,residential environment,guardianship relationship,causes of injury,fracture type,fracture treatment modality,duration of braking,presence of rehabilitation physician's guidance,and compliance of the affected person.Univariate and multifactorial analyses were performed to select risk factors affecting FAKJ.Poor recovery from FAKJ was defined as the presence of pain,reduced joint motion,or claudication in one of the affected limbs during follow-up period.Results Fifty-one patients out of 364 FAKJ patients presented with poor recovery,with an incidence of 14.01%,35 patients(9.61%)with limited knee motion,10 patients(2.75%)with knee pain,5 patients(1.37%)with functional claudication,and 1 patient(0.27%)with re-fracture.Univariate analysis revealed statistically significant differences in ages,type of fracture braking time and affected party compliance between two groups(P<0.05).Analysis result showed age was greater than or equal to 7 years old[OR=1.512,95%CI(1.019,2.118),P<0.05],proximal tibial fracture[OR=3.813,95%CI(3.189,5.334),P<0.05],braking time above 4 weeks[OR=1.299,95%CI(1.081,8.418),P<0.05],and poor compliance[OR=1.282,95%CI(1.119,3.921),P<0.05]were risk factors for FAKJ.Conclusion Age was greater than or equal to 7 years old,proximal tibvial fracture,braking time was greater than or equal to 4 weeks,and patient poor compliance are risk factors that influence functional recovery of patients with FAKJ and may help clinical care to screen high-risk patients as well as to develop individualized treatment plans.

关 键 词：膝关节周围骨折 关节僵硬 疼痛 危险因素 

分 类 号：R683.42[医药卫生—骨科学]