摘要
目的探讨切开复位内固定术治疗胫骨平台骨折的临床价值,分析影响患者术后功能恢复的相关因素。方法选取2009年2月至2014年2月该院收治的胫骨平台骨折患者82例,均采用切开复位内固定术进行治疗。对临床疗效及可能影响患者术后功能恢复的因素进行分析。结果术后随访时间为3、6、9个月,平均(7.69±1.04)个月。82例患者经切开复位内固定术治疗后,骨折复位效果优66例(80.49%),良13例(15.85%),满意3例(3.66%),不满意0例(0.00%)。与术后3个月随访效果比较,术后6、9个月Rasmussen评分和关节活动度均明显提高,差异有统计学意义(P<0.05)。同时,82例患者术后有6例(7.32%)伴并发症,8例(9.76%)行二次手术。与年龄小于50岁患者比较,年龄大于或等于50岁患者术后Rasmussen评分及关节活动度均明显下降;与有糖尿病史患者比较,无糖尿病史的患者术后Rasmussen评分及关节活动度均明显提高;与有术后伴并发症患者比较,无术后并发症患者术后Rasmussen评分及关节活动度均明显提高;与术后骨折复位较差患者比较,术后骨折复位较好患者术后Rasmussen评分及关节活动度均明显提高,差异均有统计学意义(P<0.05)。进行多因素logistic回归分析发现,年龄、糖尿病史、术后并发症及术后骨折复位情况均为影响患者术后功能恢复的因素。结论切开复位内固定术对胫骨平台骨折患者具有较理想的临床治疗效果,同时,年龄、糖尿病史、术后并发症及术后骨折复位情况对患者的术后近期功能恢复具有一定影响。
Objective To probe into the clinical application value of open reduction and internal fixation for treating fractures of tibial plateau, and to analyze the related factors affecting postoperative functional recovery. Methods 82 patients with tibial plateau fracture in our hospital from February 2009 to February 2014 were selected and treated with open reduction and internal fixation. The clinical effects and the factors possibly affecting the postoperative functional recovery were analyzed. Results 82 cases were followed up for 3,6,9 months with an average of（7.69±1.04） months. After the treatment of open reduction and internal fixation, the fracture reduction effect was excellent in 66 cases （80.49%）, good in 13 cases （ 15.85% ）, satisfactory in 3 cases（3.66% ） and unsatisfactory in 0 case. Compared with the effect at postoperative 3-month follow up ,the Rasmussen scores and joint activity scores at postoperative 6,9 months were significantly increased with statistical difference （P〈0.05）. Meanwhile among 82 cases, 6 cases （7.32%） developed complications and 8 cases （9.76%） were performed the second surgery. Compared with the cases aged〈50 years old,the Rasmussen scores and joint activity scores in the cases aged ≥50 years old the were decreased significantly ; compared with the cases of diabetes history, the Rasmussen scores and joint activity scores in the cases without diabetes history were increased significantly ; compared with the cases of postoperative complications, the Rasmussen scores and joint activity scores in the cases with no complications were increased significantly; compared with the cases of poor postoperative reduction of fracture, the Rasmussen scores and joint activity scores in the cases of better postoperative reduction were increased significantly, the differences were statistically significant （P〈0.05）. The multi-factor Logistic regression analysis found that the age, diabetes history, postoperative complications and postoperative fracture redu
出处
《现代医药卫生》
2016年第2期200-202,共3页
Journal of Modern Medicine & Health
关键词
胫骨骨折/外科学
骨折固定术
内
功能恢复
切开复位内固定术
影响因素
Tibial fractures/surgery
Fracture fixation,internal
Recovery of function
Open reduction and internal fixation
Related factors
