牵引床复位内固定治疗老年股骨粗隆间骨折术后膝关节内侧软组织损伤的影响因素分析  

Effect of traction bed reduction and internal fixation on intertrochanteric fracture of femur in elderly and analysis of influencing factors of medial soft tissue injury of knee joint after operation

作　　者：郭俊超 杨亚娟 王云云 GUO Jun-chao;YANG Ya-juan;WANG Yun-yun(Department of Orthopedics,Xuchang People's Hospital,Xuchang,Henan 461000,China;Disinfection Supply Center,Xuchang People's Hospital,Xuchang,Henan 461000,China)

机构地区：[1]许昌市人民医院骨外二科,河南许昌461000 [2]许昌市人民医院消毒供应中心,河南许昌461000

出　　处：《医药论坛杂志》2025年第1期75-79,共5页Journal of Medical Forum

摘　　要：目的分析牵引床复位股骨近端防旋髓内钉(proximal femoral anti-rotation intramedullary nail,PFNA)内固定治疗老年股骨粗隆间骨折术后膝关节内侧软组织损伤的影响因素。方法选取2020年1月—2022年12月在许昌市人民医院诊治的老年股骨粗隆间骨折患者102例,统计术后膝关节内侧软组织损伤情况,并分析术后关节内侧软组织损伤的影响因素。结果术后17例患者发生膝关节内侧软组织损伤,发生率为16.67%。将17例术后膝关节内侧软组织损伤患者纳入为损伤组,其余纳入为非损伤组,经单因素分析损伤组年龄、骨密度、骨折Evans分型、股骨粗隆是否复位、骨质疏松分级与非损伤组比较,差异有统计学意义(P<0.05)。以是否发生膝关节内侧软组织损伤为因变量,以单因素分析中P<0.05的因素为自变量,经二元logistic回归分析,年龄≥70岁、骨折Evans分型Ⅱ型和Ⅲ型是术后膝关节内侧软组织损伤的危险因素[OR(95%CI):10.777(2.122~54.731),29.882(2.251~396.666),33.147(2.897~379.255);P均<0.05],骨密度≥-2.5SD是术后膝关节内侧软组织损伤的保护因素[OR(95%CI):0.198(0.041~0.949),P<0.05]。结论术后膝关节内侧软组织损伤和年龄、骨折Evans分型以及骨密度有关。Objective To analyze the influencing factors of soft tissue injury on the medial side of the knee joint in elderly patients with intertrochanteric fractures treated with traction bed reduction and proximal femoral anti-rotation intramedullary nail(PFNA)internal fixation.Methods Totally 102 cases of elderly patients with intertrochanteric fracture in the Xuchang People's Hospital from January 2020 to December 2022 were randomly divided into two groups,51 cases in the control group and 51 cases in the research group.The control group was treated with dynamic hip screw,while the research group was treated with traction bed reduction PFNA internal fixation.The perioperative related indicators,clinical treatment efficacy and postoperative soft tissue injury of medial joint were compared between the two groups,and the influencing factors of postoperative soft tissue injury of medial joint were analyzed.Results Among 17 patients experienced soft tissue injury on the medial side of the knee joint after surgery,with an incidence rate of 16.67%.All these 17 patients with soft tissue injuries on the medial side of the knee joint after surgery were included in the injury group,while the rest were included in the non injury group.Univariate analysis was conducted to compare the age,bone density,fracture Evans classification,reduction of femoral trochanter,and osteoporosis grading of the injury group with those of the non injury group,and the difference was statistically significant(P<0.05).Using the occurrence of medial knee soft tissue injury as the dependent variable and factors with P<0.05 in univariate analysis as independent variables,binary logistic regression analysis showed that age≥70 years and Evans fracture typesⅡandⅢwere risk factors for postoperative medial knee soft tissue injury[OR(95%CI):10.777(2.122-54.731),29.882(2.251-396.666),33.147(2.897-379.255),P<0.05],bone density≥-2.5SD was a protective factor for postoperative medial soft tissue injury of the knee joint[OR(95%CI):0.198(0.041-0.949),P<0.05].Co

关 键 词：牵引床复位 股骨近端防旋髓内钉 老年股骨粗隆间骨折 膝关节 内侧软组织损伤 影响因素 

分 类 号：R687.3[医药卫生—骨科学]