CAJ | 학술논문

背景：股骨髁部复杂骨折内固定治疗后常出现膝关节功能受限，但对其发生机制及影响因素也各说不一。 　　目的：筛选分析股骨髁部复杂骨折内固定后膝关节功能受限的相关因素。 　　方法：回顾性总结121例股骨髁部复杂骨折患治疗后6及12个月回访信息，依Merchan标准评价患者膝关节功能恢复程度。对患者的性别、年龄、致伤原因、合并伤情况、皮肤软组织损伤情况、骨折类型、固定方式、手术时机、内固定后石膏固定情况、切口愈合情况、骨愈合情况及功能锻炼情况等12项因素进行多元逐步回归分析。总结出影响因素。 　　结果与结论：以内固定后是否发生膝关节功能受限作为因变量 Y，将上述单因素分析中有统计学意义的因素作为自变量X，选择多元逐步回归分析统计方法进行多因素分析，结果表明患者的性别(X1)、是否合并伤(X3)和软组织损伤情况(X4)及手术时机(X6)共4个因素不能引入模型，说明上述4个因素与内固定后是否发生膝关节功能受限无显著相关。其他8个因素则进入多因素分析模型，表明患者内固定前致伤原因(X2)、内固定前骨折类型(X5)、内固定方式的选择(X7)和植骨与否(X8)、内固定后石膏固定与否(X9)、内固定后膝关节功能锻炼与否(X10)及伤口愈合情况(X11)、骨愈合程度(X12)等8个危险因素与股骨髁部复杂骨折内固定后膝关节功能受限有较密切的关系。
배경：고골과부복잡골절내고정치료후상출현슬관절공능수한，단대기발생궤제급영향인소야각설불일。 　　목적：사선분석고골과부복잡골절내고정후슬관절공능수한적상관인소。 　　방법：회고성총결121례고골과부복잡골절환치료후6급12개월회방신식，의Merchan표준평개환자슬관절공능회복정도。대환자적성별、년령、치상원인、합병상정황、피부연조직손상정황、골절류형、고정방식、수술시궤、내고정후석고고정정황、절구유합정황、골유합정황급공능단련정황등12항인소진행다원축보회귀분석。총결출영향인소。 　　결과여결론：이내고정후시부발생슬관절공능수한작위인변량 Y，장상술단인소분석중유통계학의의적인소작위자변량X，선택다원축보회귀분석통계방법진행다인소분석，결과표명환자적성별(X1)、시부합병상(X3)화연조직손상정황(X4)급수술시궤(X6)공4개인소불능인입모형，설명상술4개인소여내고정후시부발생슬관절공능수한무현저상관。기타8개인소칙진입다인소분석모형，표명환자내고정전치상원인(X2)、내고정전골절류형(X5)、내고정방식적선택(X7)화식골여부(X8)、내고정후석고고정여부(X9)、내고정후슬관절공능단련여부(X10)급상구유합정황(X11)、골유합정도(X12)등8개위험인소여고골과부복잡골절내고정후슬관절공능수한유교밀절적관계。
BACKGROUND:Knee joint function limitation often occurs after internal fixation of complex femoral condyle fractures, but the mechanism and its influencing factors are also unclear. OBJECTIVE:To screen and analyze the relevant factors of knee joint function limitation after internal fixation of complex femoral condyle fractures. METHODS:We retrospectively summarized postoperative fol ow-up data of 6 and 12 months from 121 patients with complex femoral condyle fractures. Knee joint function recovery was evaluated according to Merchan criteria. A multiple stepwise regression analysis was carried out in terms of gender, age, causes, concomitant injuries, skin and soft tissue injury, fracture type, fixed method, operation time, postoperative plaster fixed situation, healing of postoperative incision, bone healing and postoperative functional exercises, to summarize the relevant influencing factors for knee joint function limitation. RESULTS AND CONCLUSION:Whether the knee joint function after internal fixation was limited acted as the dependent variable Y, and factors with statistical significance of the single factor analysis served as the independent variable X. We used the multiple stepwise regression analysis for multiple factors analysis. Results showed that the gender of patients (X1), with or without concomitant injuries (X3), soft tissue damage (X4) and operation time (X6), a total of four factors, could not be introduced into the model, suggesting that these four factors had no significant correlation with postoperative knee joint function limitation. Another eight factors could be introduced into the factor analysis model, showing that the cause of injury (X2), fracture type (X5), the choice of internal fixation (X7), with or without bone graft (X8), with or without postoperative plaster cast (X9), postoperative knee joint functional exercise or not (X10) and postoperative wound healing (X11), the degree of postoperative bone healing (X12) are closely related to postoperative knee joint function limitation in complex femoral condyles fractures.