摘要
目的探讨锁定钢板治疗桡骨远端骨折术后桡骨缩短的相关因素。方法选取2014年1月-2018年12月因桡骨远端骨折于无锡市惠山区第二人民医院、无锡市第二人民医院行手术治疗的210例患者作为研究对象,所有患者在收住入院后均先予手法复位石膏外固定,复查X线提示骨折位置不佳,遂行掌侧入路切开复位锁定钢板内固定术。术前完善骨密度检查了解患者是否存在骨质疏松,以传统AO分类对骨折进行分型,并记录患者的性别、年龄、体质指数(BMI)、受伤至手术时间、手术时长、术前角度、术中透视角度、远端螺钉数目、远端螺钉距桡骨远端距离、术后开始锻炼时间。在术后1个月对患者进行X线复查,判断是否出现复位失败。根据复位情况分为复位成功组和复位失败组,利用统计学软件对可能的危险因素进行分析。结果本研究纳入的210例患者中,术后复位失败的患者37例,复位成功的患者173例。其中,失败组患者的年龄、BMI指数、受伤至手术时间、AOC型骨折、骨质疏松比例、远端螺钉距桡骨远端距离均明显大于成功组,差异具有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄、受伤至手术时间、AO分型、骨质疏松、远端螺钉距桡骨远端距离是桡骨远端锁定钢板复位失败的独立危险因素(P<0.05)。结论高龄、伤后肿胀高峰期、AOC型骨折、骨质疏松、远端螺钉距桡骨远端距离过大是影响桡骨远端锁定钢板复位预后的独立危险因素,术后早期功能锻炼对骨折复位无明显影响。
ObjectiveTo explore the related factors of radius shortening after locking plate in the treatment of distal radius fracture.MethodsA total of 210 patients were selected with distal radius fracture treated in Wuxi Second People′s Hospital of Huishan District and Wuxi Second People′s Hospital from January 2014 to December 2018 as the subjects.All patients were treated with manual reduction and plaster external fixation after admission.X-ray showed that the position of fracture was serious,so the metacarpal approach was performed with open reduction and locking plate internal fixation.Bone mineral density(BMD)was performed before operation to find out whether there was osteoporosis among patients.Fracture was classified according to traditional AO classification.The sex,age,body mass index(BMI),time from injury to operation,length of operation,preoperative angle,intraoperative perspective,number of distal screws,distance from distal screw to distal radius and postoperative exercise time,were recorded.One month after operation,the patients were subjected to re-examination by X-ray to determine whether the reduction failed or not.According to the reduction situation,the patients were divided into reduction success group and reduction failure group.The possible risk factors were analyzed by statistical software.ResultsOf the 210 patients included in this study,37 were failed in postoperative reduction and 173 were successful in reduction.The age,BMI index,time from injury to operation,type C of AO,the proportion of osteoporosis and the distance from distal screw to distal radius in the failure group were significantly higher than those in the successful group(P<0.05).Multivariate Logistic regression analysis showed that age,time from injury to operation,AO classification,osteoporosis and distal distance from distal screw to distal radius were independent risk factors for failure of distal radius locking plate reduction.Conclusion Old age,peak swelling after injury,AOC fracture,osteoporosis and excessive distance be
作者
祝浩刚
邹烽
江劲明
顾羊林
ZHU Haogang;ZOU Feng;JIANG Jingming;GU Yanglin(Department of Orthopaedics,Huishan District Second People′s Hospital of Wuxi,Wuxi Jiangsu 214000,China;Department of Orthopaedics,Second People′s Hospital of Wuxi,Wuxi Jiangsu 214002,China)
出处
《新疆医科大学学报》
CAS
2019年第12期1598-1601,1605,共5页
Journal of Xinjiang Medical University
基金
江苏省“六大人才高峰”高层次人才C类资助项目(2016-WSW-099)
