摘要
目的回顾性分析踝关节骨折伴随三角韧带断裂患者的临床资料,分析骨折修复方式的不同对患者预后的影响。方法收集2011年1月至2015年12月收治的踝关节骨折患者,筛查后纳入研究;骨折患者的人口学资料、合并伤情、受伤至治疗时间、骨折类型、术中出血量、修复方式作为影响预后的因素纳入研究,以围术期指标、术后并发症情况、疼痛评分及功能评分作为评价患者预后是否良好的指标;对不同分组患者间的评价资料进行分析;单因素Logistic回归分析各因素对患者预后的影响,多因素Logistic回归探讨修复方式对患者预后的影响。结果筛查后共纳入61例患者为研究对象,根据修复的方式分为未修复组(16例)和修复组(45例),其中修复组包括浅层修复组(18例)、深层修复组(16例)和完全修复组(11例);与未修复组比较,修复组患者术后并发症减少,VAS评分降低,AOFAS评分升高,差异均有统计学意义(P<0.05);单因素方差分析显示,修复组患者之间的术后并发症、VAS评分、AOFAS评分差异有统计学意义(P<0.05);单因素Logistic回归分析显示,年龄、合并伤、受伤至治疗时间、骨折类型的差异是患者预后的危险因素,修复三角韧带以及深浅层修复是患者预后的保护因素,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,浅层修复是伴随三角韧带断裂的踝关节骨折患者预后的独立保护因素(Or=0.312,95%CI:0.664～1.093,P=0.021)。结论踝关节骨折伴随三角韧带断裂的患者可行浅层修复三角韧带的方式,以提升患者的预后。
Objective To analyze the clinical data of patients with ankle fracture complicated by triangular ligament disrupt in order to investigate the effects of difference repair methods on prognosis of patients.Methods The patients with ankle fracture who were treated in our hospital from January 2011 to December 2015 were enrolled in the study.The demography data,combined injury,time from injure to therapy,classification of fracture,intraoperative bleeding volume,repair methods as factors influencing prognosis.were investigated,moreover,the peroperative period indexes,postoperative complications,pain score and function score were collected as evaluation indexes of patient’s prognosis.In addition the data were statistically analyzed among groups,and the effects of different factors on prognosis of patients were analyzed by univariate Logistic repression,moreover,the effects of repair modes on patient’s prognosis were analyzed by multiple Logistic repression.Results A total of 61 patients were enrolled as research objects through screening.According to different repair methods,these patients were divided into non-repair group(n=16)and repair group(n=45),and repair group was redivided into superficial layer repair group(n=18),deep layer repair group(n=16)and complete repair group(n=11).As compared with those in non-repair group,the postoperative complications,VAS score in repair group were significantly decreased,however AOFAS scores were significantly increased(P<0.05).The one-factor analysis of variance showed that there were significant differences in postoperative complications,VAS and AOFAS scores among different repair groups(P<0.05).The univariate Logistic repression showed that patient’s age,combined injury,the difference of fracture type and time from injure to therapy were risk factors influencing patient’s prognosis,however,repair of triangular ligament,deep and superficial layer repair were the protective factors influencing patient’s prognosis(P<0.05).Besides multiple Logistic repression showed that
作者
刘智
詹俊锋
周志强
王明
高锋
LIU Zhi;ZHAN Junfeng;ZHOU Zhiqiang(Departmengt of Surgery,People’s Hospital of Dongsheng District of Ordos City,Inner Mongolia,Ordos 017000,China)
出处
《河北医药》
CAS
2018年第14期2107-2110,共4页
Hebei Medical Journal
关键词
踝关节骨折
三角韧带
浅层修复
ankle fracture
triangular ligament
superficial layer repair
