摘要
目的 探讨影响股骨髁上骨折内固定术后患者膝关节功能恢复的相关因素.方法 回顾性分析2008年1月至2011年12月期间河北医科大学第三医院收治且符合纳入标准的105例股骨髁上骨折内固定术后患者资料,男60例,女45例;平均年龄为41.4岁.骨折AO分型：A1型19例,A2型23例,A3型63例.对可能影响术后膝关节功能恢复的患者年龄、性别、职业、地区、季节、受伤侧别、骨折AO分型、合并伤、住院时间、致伤原因、术前合并内科疾病、骨质疏松、受伤至手术时间、手术入路、复位方式、内固定方式等22个相关因素进行多重线性回归模型分析,筛选出主要的相关因素.结果 105例患者术后获2～6年（平均3.7年）随访.末次随访时患者美国膝关节协会评分平均为144.7分.单因素分析中不同年龄、骨折AO分型、复位方式、内固定方式、术后非负重下地时间、致伤原因、是否有骨质疏松、术后是否行持续被动活动、是否有合并伤的患者美国膝关节协会评分差异有统计学意义（P＜0.05）.多重线性回归模型分析得出回归方程为：Y=186.87-21.74术后非负重下地时间-7.23骨折AO分型-19.59年龄＋10.30骨质疏松＋10.68合并伤.对膝关节功能恢复的影响从大到小依次为：术后非负重下地时间、年龄、骨折AO分型、合并伤、骨质疏松.结论 高龄、复杂骨折、伴有严重合并伤、患有骨质疏松及术后下地活动晚的患者膝关节功能恢复较差.
Objective To analyze the factors related to functional recovery of the knee joint following surgery for the supracondylar femoral fractures between 2008 January and 2011 December at our hospital.Methods Complete clinical data of 105 eligible patients who had undergone surgery for supracondylar femoral fracture between 2008 January and 2011 December at our hospital were collected through the PACS system and case reports checking system.They were 60 men and 45 women,with an average age of 41.4 years.By AO classification,19 cases were of A1,23 cases of A2,and 63 cases of A3 type.To identify the major factors,multiple linear regression was used to analyze the 22 factors that might have influenced functional recovery of the knee joint,such as age,gender,occupation,resident location,season,affected side,AO type,combined injury,in-hospital time,injury mechanism,preoperative concomitant disease,osteoporosis,interval from injury to surgery,operative approach,reduction method,and internal fixation method.Results This cohort was followed up from 2 to 6 years （average,3.7 years）.The knee functional scores at the last follow-up averaged 144.7 points.Single factor analysis revealed that age,injury mechanism,reduction method,internal fixation method,postoperative non-weight-bearing ambulation time,AO type,osteoporosis,continuous passive motion exercise,and combined injury rendered a significant difference in knee functional scores （P 〈 0.05）.Multiple linear regression yielded a regression equation of Y=186.87-21.74 postoperative non-weight-bearing ambulation time-7.23 AO type-19.59 age ＋ 10.30 osteoporosis ＋ 10.68 combined injury.The factors that influenced the knee functional recovery from the most to the least were postoperative non-weight-bearing ambulation time,age,AO type,combined injury and osteoporosis.Conclusion The patients with senior age,complicated fracture,severe combined injury,osteoporosis and late postoperative ambulation had poor functional recovery of the knee joint.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2014年第11期978-982,共5页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学基金青年科学基金项目（81401789）
关键词
股骨骨折
功能恢复
流行病学因素
回归分析
Femoral fractures
Recovery of function
Epidemiologic factors
Regression analysis
