摘要
目的探讨胫骨平台后方骨挫伤的危险因素。方法回顾性分析2017年10月至2019年11月因膝关节外伤而就诊的155例患者资料,男100例,女55例,年龄(40.0±10.6)岁(范围18~60岁)。观察患者胫骨平台后方是否存在骨挫伤,并通过影像学资料收集患者是否同时存在前十字韧带(anterior cruciate liagment,ACL)、后十字韧带(posterior cruciate ligament, PCL)、内侧副韧带(medial collateral ligament, MCL)、外侧副韧带(lateral collateral ligament, LCL)及腓骨小头损伤,通过病历资料收集患者受伤机制、年龄、性别及受伤侧别及体格检查等资料,分析各事件对胫骨平台后方骨挫伤发生的相关危险因素。结果 155例患者中有92例发生骨挫伤,男56例,女36例;年龄(39.6±10.5)岁(范围19~55岁);右侧膝关节损伤45例,左侧47例。ACL损伤情况:ACL完全断裂42例,部分断裂34例,无损伤16例;PCL损伤18例,无损伤74例;非接触性损伤57例,接触性损伤35例;腓骨小头损伤57例,无损伤35例;MCL损伤44例,MCL无损伤48例;LCL损伤13例,LCL无损伤79例。单因素分析结果显示ACL损伤(χ^(2)=18.345)、腓骨小头损伤(χ^(2)=5.495)与胫骨平台后方骨挫伤存在明显差异(均P<0.05);性别(χ^(2)=1.315)、患膝侧别(χ^(2)=0.880)、损伤机制(χ^(2)=3.467)、年龄(t=0.664)、LCL损伤(χ^(2)=0.010)、MCL损伤(χ^(2)=0.029)及PCL损伤(χ^(2)=0.161)等差异无统计学意义(均P>0.05)。对组间存在差异的变量进行Logistic分析,结果显示ACL损伤、腓骨小头损伤均是胫骨后方骨挫伤形成的独立危险因素(均P<0.05)。ACL完全断裂出现胫骨平台后方骨挫伤的可能性比ACL部分断裂明显增大(OR=2.695,P=0.021)。结论 ACL损伤与腓骨小头损伤是胫骨平台后方骨挫伤的独立危险因素;ACL完全断裂较部分断裂更容易合并胫骨平台后方骨挫伤。
Objective To investigate the correlation between anterior cruciate ligament injury and the bone contusion in the posterior of tibial plateau and the risk factors of it.Methods Data of patients with knee trauma who came to our hospital from Oct.2017 to Nov.2019 were retrospectively analyzed.There are 100 males and 55 females with an average age of 40.0±10.6 years(range,18-60).Bone contusion in the posterior tibial plateauand anterior cruciate ligament,posterior cruciate ligament,medial col⁃lateral ligament,lateral collateral ligament and fibula injury were evaluated through imaging data,and injury mechanism,age,sex and the side of injury were collected from medical records.The effect of events on bone contusion in the posterior of tibial plateau was analyzed.Results Bone contusion occurred in 92 of the 155 patients(56 males and 36 females),with an average age of 39.6±10.5 years(range,19-55 years).There were 45 cases on right knee and 47 cases on the left side.ACL injury:ACL was completely ruptured in 42 cases,partially ruptured in 34 cases,and had no injury in 16 cases.There were 18 cases with PCL injury,and 74 cases without any injury.There were 57 cases of non-contact injury,and 35 cases of contact injury.There were 57 cases with fibu⁃lar head injury,and 35 cases without.There were 44 cases with MCL injury,and 48 cases without.There were 13 cases with LCL injury,and 79 cases without.ACL injury degree(χ^(2)=18.345,P<0.05)and the head of fibula(χ^(2)=5.495,P<0.05)injury were sig⁃nificantly different between the two groups.There was no significant difference in male ratio(χ^(2)=1.315,P>0.05),knee side(χ^(2)=0.880,P>0.05),injury mechanism(χ^(2)=3.467,P>0.05),age(t=0.664,P>0.05),LCL(χ^(2)=0.010,P>0.05)、MCL(χ^(2)=0.029,P>0.05)and PCL(χ^(2)=0.161,P>0.05).ACL injury was an independent risk factor for bone contusion in the posterior of tibial plateau(P<0.05)and the injury of fibula head was an independent risk factor for the formation of bone contusion in the posterior of tibial plateau(P<0.05)according
作者
冯青
张炳耀
杨洋
Feng Qing;Zhang Bingyao;Yang Yang(The Fourth Department of Orthopaedics,Cangzhou People’s Hospital,Cangzhou 061000,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2021年第4期227-232,共6页
Chinese Journal of Orthopaedics
基金
河北省科技计划项目(162777235)。
关键词
前交叉韧带
膝损伤
危险因素
Anterior cruciate ligament
Knee injuries
Risk factors
