| 陈奇,魏长宝,徐小峰,等.膝关节周围骨折术后关节不稳的危险因素分析.骨科,2015,6(4): 169-172. |
| 膝关节周围骨折术后关节不稳的危险因素分析 |
| Analysis of risk factors of postoperative joint instability in fractures around the knee |
| 投稿时间：2015-03-11 |
| DOI：10.3969/j.issn.1674-8573.2015.04.001 |
| 中文关键词: 膝关节 骨折 关节不稳 危险因素 回归分析 |
| 英文关键词: Knee joint Fractures, bone Joint instability Risk factor Regression analysis |
| 基金项目:江苏大学临床科技发展基金（No.JLY2010130） |
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| 中文摘要: |
| 目的 探讨造成膝关节周围骨折术后关节不稳的危险因素。方法 从我科2010年10月至2013年7月住院患者中选取符合纳入标准的膝关节周围骨折病例116例，其中男67例，女49例，平均年龄（47.3±14.4）岁。车祸伤54例，摔伤50例，高处坠落伤6例，机器绞伤3例，殴打伤2例，重物砸伤1例。所有患者均随访12个月。选取年龄、性别、糖尿病史、原发暴力、骨折程度、开放性损伤、韧带损伤、关节囊损伤、术中出血量、手术时间、冠状位胫股角、伸直受限、屈曲受限为初筛因素，先纳入一元Logistic回归模型，再将有关联性的因素纳入多元Logistic回归模型，寻求造成膝关节周围骨折术后关节不稳的危险因素。结果一元Logistic回归分析发现，骨折程度、开放性骨折、韧带损伤、关节囊损伤情况、术中出血量和关节屈曲受限与术后关节不稳有关，差异均有统计学意义（均P<0.05）。多元Logistic回归分析发现，上述关联因素中，关节囊损伤和屈曲受限是造成膝关节周围骨折术后关节不稳的危险因素，差异均有统计学意义（均P<0.05）。结论 关节囊损伤和屈曲受限是造成膝关节周围骨折术后关节不稳的主要危险因素。因此，在膝关节周围骨折的外科治疗过程中，积极修复损伤的关节囊，避免术中切开关节囊，术后早期功能锻炼，避免关节屈曲受限，能降低术后关节不稳的发生率，促进关节功能的恢复。 |
| 英文摘要: |
| Objective To investigate the risk factors of joint instability after open reduction and internal fixation for the fractures around the knee. Methods 116 cases of fractures around the knee from Oct. 2010 to Jul. 2013 were selected from the Affiliated Hospital of Jiangsu University on inclusion criteria, including 67 males and 49 females, with an average age of (47.3±14.4) years. There were 54 cases of traffic accident injury, 50 cases of fall injury, 6 cases of high falling injury, 3 cases of machine accident, 2 cases of fight violence, and 1 case of injury by crashing object. All cases were followed up for 12 months. Age, gender, history of diabetes mellitus, primary trauma, severity of fracture, open injury, ligament injury, joint capsule injury, intra-operative blood bleeding, operation time, tibial-femoral angle, extend limitation, and flexion limitation were considered to be the probable risk factors. These factors were firstly put into univariate logistic regression model to find out relevant factors, then, relevant factors were put into multivariate analysis logistic regression model to find out risk factors. Results Severity of fracture, open injury, ligament injury, joint capsule injury, intra-operative blood bleeding, and flexion limitation were found to be relevant factors by univariate logistic regression analysis (all P<0.05). Joint capsule injury and flexion limitation were risk factors of joint instability after surgery for the fractures around the knee by multivariate analysis logistic regression analysis (all P<0.05). Conclusion Joint capsule injury and flexion limitation were risk factors of joint instability after surgery for the fractures around the knee. Thus, in the surgical treatment for the fractures around the knee, to repair the injured joint capsule, avoid opening the joint capsule, and perform early rehabilitation were beneficial to the stability and function of the knee. |
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