摘要
目的分析胫骨平台骨折患者钢板内固定术后并发创伤性关节炎情况及其危险因素。方法选取2019年8月—2024年5月德州市陵城区中医院收治的98例胫骨平台骨折患者为研究对象,根据钢板内固定术治疗后创伤性关节炎的发生情况将其分为并发组与未并发组。比较两组患者的一般及临床资料,包括性别、年龄、体质指数、是否合并交叉韧带损伤、钢板类型、是否合并骨质疏松、是否合并半月板损伤、Schatzker分型、术后是否康复训练、致伤能量、受伤至手术时间。以单因素分析中相关因素为自变量并赋值,以创伤性关节炎发生情况为因变量,进一步行多因素Logistic回归分析。结果98例胫骨平台骨折患者钢板内固定术后患者中,创伤性关节炎发生20例,未发生78例,创伤性关节炎发生率为20.41%(20/98)。单因素分析显示,两组性别、年龄、体质指数、是否合并交叉韧带损伤、钢板类型、是否合并半月板损伤比较,组间差异无统计学意义(P>0.05);两组是否合并骨质疏松、Schatzker分型、术后是否康复训练、致伤能量、受伤至手术时间比较,组间差异有统计学意义(P<0.05);Logistic回归分析显示,合并骨质疏松、Schatzker分型为IV~VI、术后未康复训练、高能量致伤、受伤至手术时间≥1周是影响胫骨平台骨折患者钢板内固定术后并发创伤性关节炎的独立危险因素(P<0.05,OR>1)。结论胫骨平台骨折患者钢板内固定术后并发创伤性关节炎是由合并骨质疏松、Schatzker分型为IV-VI、术后未康复训练、高能量致伤、受伤至手术时间≥1周等综合作用所致,临床还需及时筛查伴高危因素的患者,做好预防工作。
Objective To analyze the situation and risk factors of traumatic arthritis in patients with tibial plateau fracture after plate internal fixation.Methods A total of 98 patients with tibial plateau fracture admitted to Lingcheng District Hospital of Traditional Chinese Medicine in Dezhou City from August 2019 to May 2024 were selected as the research objects.According to the occurrence of traumatic arthritis after plate internal fixation,they were divided into a concurrent group and a non-concurrent group.The general and clinical data of the two groups were compared,including gender,age,body mass index,whether there was cruciate ligament injury,plate type,whether there was osteoporosis,whether there was meniscus injury,Schatzker classification,whether there was postoperative rehabilitation training,injury-causing energy,and the time from injury to operation.The relevant factors in the univariate analysis were used as independent variables and assigned values,and the occurrence of traumatic arthritis was used as dependent variable.Multivariate Logistic regression analysis was performed.Results Among the 98 patients with tibial plateau fracture after plate internal fixation,traumatic arthritis occurred in 20 cases and did not occur in 78 cases,the incidence of traumatic arthritis was 20.41%(20/98).Univariate analysis showed that there were no significant differences in gender,age,body mass index,cruciate ligament injury,plate type and meniscus injury between the two groups(P>0.05).There were statistically significant differences between the two groups in whether osteoporosis was combined,Schatzker classification,postoperative rehabilitation training,injury-causing energy,and injury-operation time(P<0.05).Logistic regression analysis showed that osteoporosis,Schatzker type IV-VI,no postoperative rehabilitation training,high-energy injury,and≥1 week from injury to surgery were independent risk factors for postoperative traumatic arthritis in patients with tibial plateau fracture after plate fixation(P<0.05,OR>1).Conclusion Traumatic arthritis in patients with tibial plateau fracture after plate internal fixation is caused by a combination of osteoporosis,Schatzker classification as IV~VI,postoperative rehabilitation training,high-energy injury,and≥1 week from injury to operation,etc.Patients with high-risk factors should be screened in time for clinical prevention.
作者
祝天平
ZHU Tianping(Department of Orthopedics,Lingcheng District Hospital of Traditional Chinese Medicine,Dezhou City,Dezhou 253000,China)
出处
《反射疗法与康复医学》
2024年第24期76-79,共4页
Reflexology And Rehabilitation Medicine
关键词
胫骨平台骨折
钢板内固定术
创伤性关节炎
危险因素
Tibial plateau fracture
Plate internal fixation
Traumatic arthritis
Risk factors
