CAJ | 학술논문

目的探讨导致儿童肱骨髁上骨折闭合复位失败的危险因素,从而指导临床治疗.方法回顾性分析2008年2月至2013年2月于本院治疗的138例肱骨髁上骨折患儿的临床资料,记录其年龄、BMI指数、受伤机制、骨折类型、受伤至手术时间、最大初始移位(对位及旋转).采用均值比较或卡方检验对以上因素进行单因素分析,再采用多因素logistic分析对可能的危险因素进行分析,以明确肱骨髁上骨折闭合复位失败的相关因素.结果单因素分析显示BMI指数、骨折类型、受伤至手术时间、最大初始移位与儿童肱骨髁上骨折闭合复位失败有显著相关性,多因素Logistic回归分析显示,骨折类型、受伤至手术时间、最大初始移位是儿童肱骨髁上骨折闭合复位失败的独立危险因素.结论伤后肿胀高峰期、GartlandⅢ型骨折、初始移位大的患儿闭合复位失败机率高,选择复位及固定方式时应仔细考虑这些危险因素.
목적 탐토도치인동굉골과상골절폐합복위실패적위험인소,종이지도림상치료.방법 회고성분석2008년2월지2013년2월우본원치료적138례굉골과상골절환인적림상자료,기록기년령、BMI지수、수상궤제、골절류형、수상지수술시간、최대초시이위(대위급선전).채용균치비교혹잡방검험대이상인소진행단인소분석,재채용다인소logistic분석대가능적위험인소진행분석,이명학굉골과상골절폐합복위실패적상관인소.결과 단인소분석현시BMI지수、골절류형、수상지수술시간、최대초시이위여인동굉골과상골절폐합복위실패유현저상관성,다인소Logistic회귀분석현시,골절류형、수상지수술시간、최대초시이위시인동굉골과상골절폐합복위실패적독립위험인소.결론 상후종창고봉기、GartlandⅢ형골절、초시이위대적환인폐합복위실패궤솔고,선택복위급고정방식시응자세고필저사위험인소.
Objective To investigate the risk factors of failure in closed reduction for supracondylar fracture of humerus in children and to guide clinical treatment.Methods Children with supracon dylar fractures who were treated in our hospital from February 2008 to February 2013 were studied.Age,BMI index,mechanism of injury,fracture type,duration from injury to surgery,the maximum initial displacement (right position and rotation) were analyzed.Mean comparison or chi-square test was used for univariate analysis and multivariate logistic regression analysis was used to identify possible risk factors.Results Univariate analysis showed that BMI index,fracture type,duration from injury to surgery and the maximum initial displacement were significantly correlated with the failure in closed reduction.Multivariate logistic regression analysis showed that the type of fracture,duration from injury to surgery and the maximum initial displacement were independent risk factors.Conclusions Swelling peak time,Gartland type Ⅲ fractures and the maximum initial displacement are risk factors for the failure in closed reduction for supracondylar fracture of humerus in children,which should be carefully considered when selecting reduction and fixation mode.