胫骨平台骨折术后膝关节功能不稳定的现状及影响因素研究  

Study on the current situation and influencing factors of knee functional instability after tibial plateau fracture surgery

作　　者：周浩霖 刘青春 ZHOU Hao-lin;LIU Qing-chun(Orthopedics Department,Liqun Hospital of Putuo District,Shanghai 200333,China)

机构地区：[1]上海市普陀区利群医院骨科,200333

出　　处：《中国实用医药》2025年第5期15-18,共4页China Practical Medicine

基　　金：上海市卫生健康委员会项目(项目编号:201940490)。

摘　　要：目的探讨胫骨平台骨折术后膝关节功能不稳定的现状及影响因素。方法回顾性选取80例接受胫骨平台骨折手术的患者为研究对象,根据术后膝关节功能稳定情况分为稳定组(61例)和不稳定组(19例)。收集两组患者的临床资料进行单因素分析,采用多因素Logistic回归分析术后膝关节功能不稳定的危险因素。结果特种外科医院(HSS)评分:80例患者中,HSS评分≤69分19例,占23.75%。膝关节功能稳定性试验结果:80例患者中,临床试验评估中出现膝关节功能不稳定19例,占23.75%。两组性别、年龄、体质量指数(BMI)、骨折部位、手术方式比较,差异无统计学意义(P>0.05);两组Schatzker骨折分型、是否合并膝关节周围损伤、是否出现术后并发症、是否进行康复训练比较差异显著(P<0.05)。多因素Logistic回归分析显示:Schatzker骨折分型Ⅳ~Ⅵ型(OR=1.863)、合并膝关节周围损伤(OR=1.699)、术后并发症(OR=2.204)、未进行康复训练(OR=1.745)是胫骨平台骨折术后膝关节功能不稳定的独立危险因素(P<0.05)。结论胫骨平台骨折术后有部分患者出现膝关节功能不稳定,Ⅳ~Ⅵ型骨折、合并膝关节周围损伤、存在术后并发症、未进行康复训练等是胫骨平台骨折术后患者出现膝关节功能不稳定的危险因素。Objective To explore the status and influencing factors of knee functional instability after tibial plateau fracture surgery.Methods 80 patients undergoing tibial plateau fracture surgery were retrospectively selected as the study subjects,and were divided into stable group(61 cases)and unstable group(19 cases)according to the stability of the postoperative knee function.Clinical data from both groups were collected for univariate analysis,and multivariate regression analysis was used to analyze the risk factors of postoperative knee function instability.Results Special Surgery Hospital(HSS)score:19 of 80 patients had HSS score≤69 points,accounting for 23.75%;knee functional instability:19 of 80 patients(23.75%)showed functional instability,accounting for 23.75%.There was no significant difference in gender,age,body mass index(BMI),fracture site and surgical method between the two groups(P>0.05).There were significant differences between the two groups in comparison of Schatzker fracture type,whether there was peripheral knee injury,whether there were complications,and whether rehabilitation training was carried out(P<0.05).Multivariate Logistic regression analysis showed that typeⅣ-Ⅵfractures(OR=1.863),combined peripheral knee injuries(OR=1.699),presence of postoperative complications(OR=2.204),and no postoperative rehabilitation training(OR=1.745)were independent risk factors for knee functional instability after tibial plateau fracture surgery(P<0.05).Conclusion Some patients will have knee function instability after tibial plateau fracture surgery,typeⅣ-Ⅵfractures,combined peripheral knee injuries,presence of postoperative complications,and no postoperative rehabilitation training are the risk factors for knee functional instability after tibial plateau fracture surgery.

关 键 词：胫骨平台骨折术 膝关节功能不稳定 现状分析 影响因素 

分 类 号：R68[医药卫生—骨科学]