摘要
目的探讨踝关节骨折及行切开复位内固定后软组织并发症的发生率及其高危因素。方法对2003年6月到2004年6月在我院行踝关节骨折切开复位内固定的165例患者进行回顾性调查研究,调查内容包括骨折类型和骨折方式,是否吸烟、饮酒及服用激素,有无各类慢性疾病史等。结果165例患者中,术前有24例(14.5%)出现骨折初期的软组织损伤,术后36例(21.8%)出现软组织并发症。早期手术组(骨折12h内进行手术治疗)软组织并发症发生率为21.9%(7/32例),与延迟手术组(骨折5d后进行手术,21.8%,29/133例)的差异无统计学意义(x^2=0.000,P>0.05)。然而,延迟手术组出现严重并发症5例,早期手术组仅出现1例。高能量损伤患者(70.3%,26/37例)与未发生高能量损伤患者(7.8%,10/128例)、骨折初期即出现软组织损伤患者(75.0%,18/24例)与未出现软组织损伤患者(12.8%,18/141例)术后软组织并发症发生率的差异均有统计学意义(x^2=65.640、46.560,P值均<0.05)。使用激素及患有动脉粥样硬化、高血压、甲状腺功能低下、糖尿病、冠状动脉粥样硬化性心脏病对术后软组织并发症发生率均无显著影响(x^2=0.097、0.000、1.420、0.560、0.000、0.200,P值均>0.05)。去除高能量损伤或骨折初期软组织损伤,饮酒与不饮酒者、吸烟与不吸烟者术后软组织并发症发生率的差异均无统计学意义(P值均>0.05)。不同年龄、体重及身高者软组织并发症发生率的差异均无统计学意义(P值均>0.05)。结论高能量损伤及骨折当时就出现软组织损伤的患者在手术后较易发生软组织并发症。
Objective To investigate the incidence and risk factors for soft tissue injury and complications after acute close ankle fracture and open reduction internal fixation. Methods From July, 2003 to July 2004, the clinical data of 165 patients with closed ankle fracture in our hospital were retrospectively analyzed. The fracture types, smoking history, alcohol abuse, cortisone use, CAD and diabetes were investigated. Results Twenty-four （14.5%） patients had primary soft tissue injury before operation and soft tissue complications were noted in 36 （21.8%） patients. The incidence soft tissue complication of early operation was 21.9% （7/32）, which was not significantly different from that of delayed operation （21.8%, 29/133）. However, severe complications were noted in 5 patients who received delayed operation, only one patient receiving early operation had severe complication. Significantly higher incidences of perioperative soft tissue complications were associated with high-energy trauma （70.3%） and primary soft tissue injuries（75.0%） after fracture （X^2 = 65. 640, 46. 560, both P〈0.05）, and was not associated with use of cortisone, arthrosclerosis, hypertension, hypothyroidism, diabetes, coronary artery heart disease （X^2 = 0. 097, 0. 000, 1. 420, 0. 560, 0. 000, and 0. 200, all P ） 0.05）. Alcohol and smoking were also found not associated with postoperative soft tissue injury （both P〉0.05）. The age, body weight, and height of patients had no significant influence on the soft tissue complication （both P〉0.05）. Conclusion High-energy trauma and primary soft tissue injuries patients are liable to have the high risks of soft tissue complications after ORIF in ankle fracture.
出处
《上海医学》
CAS
CSCD
北大核心
2007年第8期572-575,共4页
Shanghai Medical Journal
关键词
骨折
踝关节
软组织
并发症
Fracture Ankle
Soft tissue
Complications
