海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
11期
1597-1599
,共3页
股骨转子间骨折%髓内固定%失败%影响因素
股骨轉子間骨摺%髓內固定%失敗%影響因素
고골전자간골절%수내고정%실패%영향인소
Intertrochanteric fracture%Intramedullary fixation%Failure%Influencing factors
目的：明确影响髓内固定失败的危险因素。方法选取2002年12月至2012年12月我院骨科收治的200例股骨转子间骨折患者作为研究对象，分析年龄、性别、骨折类型在股骨转子间骨折患者中的基础作用，比较Singh指数、基础疾病、TAD、手术时间、激素药物使用及Cleveland分位对股骨转子间骨折预后的影响。采用多因素分析方法研究股骨转子间骨折患者髓内固定失败的危险因素。结果年龄、性别对股骨转子间骨折髓内固定的结局影响较小，Ⅰ型、Ⅱ型骨折的髓内固定失败率分别为11.8%、12.8%，而Ⅲ、Ⅳ的失败率为1.9%、3.5%，差异有统计学意义(P<0.05)。TAD>25 mm者，髓内固定失败率为20.0%，较TAD<25 mm者明显升高(P<0.05)，Singh指数1~3级、合并有基础疾病的患者，其髓内固定成功率明显减低，中-中、中下、中后区域较其他位置固定有较高的术后成功率，差异有统计学意义(P<0.05)，而手术的时间、有无激素药物应用对疾病预后无影响。与多因素分析结果一致。结论骨折类型、singh指数1~3级、基础疾病、TAD是影响股骨转子间骨折髓内固定失败的重要因素。
目的：明確影響髓內固定失敗的危險因素。方法選取2002年12月至2012年12月我院骨科收治的200例股骨轉子間骨摺患者作為研究對象，分析年齡、性彆、骨摺類型在股骨轉子間骨摺患者中的基礎作用，比較Singh指數、基礎疾病、TAD、手術時間、激素藥物使用及Cleveland分位對股骨轉子間骨摺預後的影響。採用多因素分析方法研究股骨轉子間骨摺患者髓內固定失敗的危險因素。結果年齡、性彆對股骨轉子間骨摺髓內固定的結跼影響較小，Ⅰ型、Ⅱ型骨摺的髓內固定失敗率分彆為11.8%、12.8%，而Ⅲ、Ⅳ的失敗率為1.9%、3.5%，差異有統計學意義(P<0.05)。TAD>25 mm者，髓內固定失敗率為20.0%，較TAD<25 mm者明顯升高(P<0.05)，Singh指數1~3級、閤併有基礎疾病的患者，其髓內固定成功率明顯減低，中-中、中下、中後區域較其他位置固定有較高的術後成功率，差異有統計學意義(P<0.05)，而手術的時間、有無激素藥物應用對疾病預後無影響。與多因素分析結果一緻。結論骨摺類型、singh指數1~3級、基礎疾病、TAD是影響股骨轉子間骨摺髓內固定失敗的重要因素。
목적：명학영향수내고정실패적위험인소。방법선취2002년12월지2012년12월아원골과수치적200례고골전자간골절환자작위연구대상，분석년령、성별、골절류형재고골전자간골절환자중적기출작용，비교Singh지수、기출질병、TAD、수술시간、격소약물사용급Cleveland분위대고골전자간골절예후적영향。채용다인소분석방법연구고골전자간골절환자수내고정실패적위험인소。결과년령、성별대고골전자간골절수내고정적결국영향교소，Ⅰ형、Ⅱ형골절적수내고정실패솔분별위11.8%、12.8%，이Ⅲ、Ⅳ적실패솔위1.9%、3.5%，차이유통계학의의(P<0.05)。TAD>25 mm자，수내고정실패솔위20.0%，교TAD<25 mm자명현승고(P<0.05)，Singh지수1~3급、합병유기출질병적환자，기수내고정성공솔명현감저，중-중、중하、중후구역교기타위치고정유교고적술후성공솔，차이유통계학의의(P<0.05)，이수술적시간、유무격소약물응용대질병예후무영향。여다인소분석결과일치。결론골절류형、singh지수1~3급、기출질병、TAD시영향고골전자간골절수내고정실패적중요인소。
Objective To determine the risk factors related to the failure in intramedullary fixation. Methods Two hundred patients with intertrochanteric fracture admitted to Orthopedicas Department of our hospital from December 2002 to December 2012 were selected. The age, gender and influence of the type on the intertrochan-teric fracture were analyzed. And then the influence of the singh index, underlying diseases, TAD, operation time, us-ing of hormone drugs and application of Cleveland quintile on the prognosis of the intertrochanteric fracture were com-pared between two groups. Multivariate analysis was used to measure risk factors related to the failure of intramedul-lary fixation for intertrochanteric fracture. Results The outcome of intramedullary fixation for intertrochanteric frac-tures was less affected by age and gender. The failure rate in intramedullary fixation for typeⅠand typeⅡfractures were 12.8%and 11.8%with no significant difference, while 1.9%and 3.5%for typeⅢandⅣfractures with signifi-cant difference (P<0.05). The intramedullary fixation failure rate in patients with TAD above 25 mm was 20.0%, which was higher than that in patients with TAD below 25 mm (P<0.05). The success rate of intramedullary fixation decreased in patients with Singh index grade 1~3 or underlying disease. Fixation in the middle-middle, middle-inferi-or, middle-posterior area had a higher success rate of surgery with statistical difference (P<0.05), while operation time and using of hormone drugs had no effect on the prognosis of the disease. And the results were consistent with Logis-tic regression analysis. Conclusion The type of fracture, singh index 1-3 grade, underlying diseases, and TAD are important factors affecting the failure in intramedullary fixation for intertrochanteric fracture.
