CAJ | 학술논문

目的：分析影响微型钢板内固定治疗粉碎性关节周围掌指骨骨折术后手指功能的影响因素。方法采用前瞻性队列研究方法,对120例粉碎性关节周围掌指骨骨折的患者行微型钢板内固定术,测定术后手指关节总主动活动度(TAM),与对侧比较计算% TAM。将之与8个影响因素作比较,包括年龄、性别、优势手、骨折部位、钢板位置、伤后手术时间、是否关节内骨折及是否伴随软组织损伤。采用线性相关分析单变量之间的关系,确定线性相关因素后采用多元线性回归分析研究各影响因素与术后% TAM 的关系。结果线性相关分析显示骨折部位、是否合并软组织损伤和年龄与术后% TAM 有明显相关性(P <0．001)。包括这3个因素的多元线性回归模型的结果说明其与术后% TAM 有明显相关性：骨折部位(β=-0．375,P <0．001),是否合并软组织损伤(β=-0．335,P <0．001),年龄(β=-0．238, P <0．001)。结论微型钢板治疗粉碎性关节周围掌指骨骨折术后手指功能% TAM 与骨折部位、是否合并软组织损伤及年龄密切相关,指骨骨折、合并软组织损伤及高龄可明显影响术后手部功能恢复。
목적：분석영향미형강판내고정치료분쇄성관절주위장지골골절술후수지공능적영향인소。방법채용전첨성대렬연구방법,대120례분쇄성관절주위장지골골절적환자행미형강판내고정술,측정술후수지관절총주동활동도(TAM),여대측비교계산% TAM。장지여8개영향인소작비교,포괄년령、성별、우세수、골절부위、강판위치、상후수술시간、시부관절내골절급시부반수연조직손상。채용선성상관분석단변량지간적관계,학정선성상관인소후채용다원선성회귀분석연구각영향인소여술후% TAM 적관계。결과선성상관분석현시골절부위、시부합병연조직손상화년령여술후% TAM 유명현상관성(P <0．001)。포괄저3개인소적다원선성회귀모형적결과설명기여술후% TAM 유명현상관성：골절부위(β=-0．375,P <0．001),시부합병연조직손상(β=-0．335,P <0．001),년령(β=-0．238, P <0．001)。결론미형강판치료분쇄성관절주위장지골골절술후수지공능% TAM 여골절부위、시부합병연조직손상급년령밀절상관,지골골절、합병연조직손상급고령가명현영향술후수부공능회복。
Objective To study factors influencing postoperative finger function in the treatment of comminuted peri-articular metacarpal and phalangeal fractures treated with miniature plate. Methods Prospective cohort study meth-ods were used in this research. 120 cases of comminuted periarticular metacarpal and phalangeal fractures were trea-ted with miniature plate. Postoperative total active motion (TAM) of finger joints were measured and compared with contralateral, and then % TAM was calculated. Postoperative TAM was compared with eight influential factors, inclu-ding age, gender, dominant hand, fracture location, location of plate placement, operation time after injury, joint in-volvement and associated soft-tissue injury. Univariate and multivariate linear regression analysis were used to identify the degree to which variables affect % TAM at the final follow-up. Results Linear correlation analysis showed that the fracture location, associated soft-tissue injury and age were significantly correlated with postoperative % TAM (P< 0. 001). Multiple linear regression models including these three factors resulted in formulae that they had signifi-cant correlation with postoperative % TAM: fracture location (β = - 0. 375, P < 0. 001), associated soft-tissue injury (β = - 0. 335, P < 0. 001), age (β = - 0. 238, P < 0. 001). Conclusions The postoperative % TAM in the treat-ment of comminuted periarticular metacarpal orphalangeal fracture with a miniature plate is intimately correlated with fracture location, associated soft-tissue injury and age. Such factors as phalangeal fracture, associated soft-tissue in-jury and increasing age will distinctly influence postoperative hand functional rehabilitation.