膝关节周围骨折术后功能恢复的危险因素分析。

Yan Zheng, Lin-Rui Peng, Hua-Guo Zhao
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引用次数: 0

摘要

目的:通过分析未成年人膝关节周围骨折(FAKJ)的危险因素,筛选影响膝关节周围骨折功能恢复的独立因素。方法:收集2017年6月至2019年6月364例FAKJ患者的临床资料,采用Logistic回归进行单因素和多因素分析。可能的危险因素包括:年龄、性别、居住环境、监护关系、损伤原因、骨折类型、骨折治疗方式、制动时间、是否有康复医师指导、患者依从性等。单因素和多因素分析选择影响FAKJ的危险因素。FAKJ恢复不良的定义是在随访期间,其中一个受影响肢体出现疼痛、关节活动减少或跛行。结果:364例FAKJ患者中51例恢复不良,发生率为14.01%,其中膝关节活动受限35例(9.61%),膝关节疼痛10例(2.75%),功能性跛行5例(1.37%),再骨折1例(0.27%)。单因素分析显示,两组患者的年龄、骨折制动时间类型、患者依从性差异有统计学意义(POR=1.512, 95%CI(1.019, 2.118), POR=3.813, 95%CI(3.189, 5.334), POR=1.299, 95%CI(1.081, 8.418), POR=1.282, 95%CI(1.119, 3.921), p年龄大于等于7岁、胫骨近端骨折、制动时间大于等于4周、患者依从性差是影响FAKJ患者功能恢复的危险因素,有助于临床护理筛查高危患者,制定个体化治疗方案。
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[Analysis of risk factors for postoperative functional recovery of fractures around knee joint].

Objective: To screen factors independently affect functional recovery of fracture around knee joint by analyzing risk factors of fracture around knee joint (FAKJ) in minors.

Methods: Clinical data of 364 FAKJ patients were collected from June 2017 to June 2019, and Logistic regression was performed for single-factor and multivariate analysis. Possible risk factors were included, such as age, gender, residential environment, guardianship relationship, causes of injury , fracture type, fracture treatment modality, duration of braking, presence of rehabilitation physician's guidance, and compliance of the affected person. Univariate and multifactorial analyses were performed to select risk factors affecting FAKJ. Poor recovery from FAKJ was defined as the presence of pain, reduced joint motion, or claudication in one of the affected limbs during follow-up period.

Results: Fifty-one patients out of 364 FAKJ patients presented with poor recovery, with an incidence of 14.01%, 35 patients (9.61%) with limited knee motion, 10 patients (2.75%) with knee pain, 5 patients (1.37%) with functional claudication, and 1 patient (0.27%) with re-fracture. Univariate analysis revealed statistically significant differences in ages, type of fracture braking time and affected party compliance between two groups(P<0.05). Analysis result showed age was greater than or equal to 7 years old[OR=1.512, 95%CI(1.019, 2.118), P<0.05], proximal tibial fracture[OR=3.813, 95%CI (3.189, 5.334), P<0.05], braking time above 4 weeks [OR=1.299, 95%CI(1.081, 8.418), P<0.05], and poor compliance[OR=1.282, 95%CI(1.119, 3.921), P<0.05] were risk factors for FAKJ.

Conclusion: Age was greater than or equal to 7 years old, proximal tibvial fracture, braking time was greater than or equal to 4 weeks, and patient poor compliance are risk factors that influence functional recovery of patients with FAKJ and may help clinical care to screen high-risk patients as well as to develop individualized treatment plans.

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