CAJ | 학술논문

目的：探讨股骨转子间骨折内固定失败的相关因素及全髋关节置换术的治疗效果。方法回顾性分析2010~2012年收治得股骨转子间骨折及股骨胫骨骨折患者119例，收集其基本信息及临床资料，将单因素分析结果具有统计学意义的指标纳入到 Logistic 多因素回归模型当中，探讨可能影响患者股骨转子间骨折内固定失败的相关因素。总结内固定失败患者采用全髋关节置换术的治疗效果。结果单因素相关分析显示，骨骼类型、骨骼质量、骨折原因、内固定位置、复位程度和后内侧骨皮质距离均是影响患者内固定失败的危险因素，将有统计学意义的因素纳入 Logistic回归模型，结果显示，骨折类型、骨骼质量、骨质复位程度是影响患者股骨转子间骨折内固定失败最主要的危险因素。其中，骨折类型是最大的影响因素（OR =5.331）。全髋关节置换术结果显示，患者术后与术前相比，Harris 评分、疼痛评分、行走评分、功能评分、活动评分均明显的增高，差异均具有统计学意义（ P ﹤0.05）。结论骨折类型、骨骼质量、骨质复位程度是影响患者股骨转子间骨折内固定失败的危险因素。其中，骨折类型是最大的影响因素。患者内固定失败后采用全髋关节置换术进行再治疗能够获得比较满意的疗效。
목적：탐토고골전자간골절내고정실패적상관인소급전관관절치환술적치료효과。방법회고성분석2010~2012년수치득고골전자간골절급고골경골골절환자119례，수집기기본신식급림상자료，장단인소분석결과구유통계학의의적지표납입도 Logistic 다인소회귀모형당중，탐토가능영향환자고골전자간골절내고정실패적상관인소。총결내고정실패환자채용전관관절치환술적치료효과。결과단인소상관분석현시，골격류형、골격질량、골절원인、내고정위치、복위정도화후내측골피질거리균시영향환자내고정실패적위험인소，장유통계학의의적인소납입 Logistic회귀모형，결과현시，골절류형、골격질량、골질복위정도시영향환자고골전자간골절내고정실패최주요적위험인소。기중，골절류형시최대적영향인소（OR =5.331）。전관관절치환술결과현시，환자술후여술전상비，Harris 평분、동통평분、행주평분、공능평분、활동평분균명현적증고，차이균구유통계학의의（ P ﹤0.05）。결론골절류형、골격질량、골질복위정도시영향환자고골전자간골절내고정실패적위험인소。기중，골절류형시최대적영향인소。환자내고정실패후채용전관관절치환술진행재치료능구획득비교만의적료효。
Objective To investigate the influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthro-plasty treatment. Methods A retrospective analysis were performed in our hospital from 2010 to 2012. Total 119 cases of femoral intertrochanteric fractures and tibial fractures were admitted. The information in all patients were collected included basic information and clinical data. A statisti-cally significant indicators were choosen into multiple Logistic regression model,adjusting for confounding variables,and exploring the factors that may affect patients with hip fracture fixation failure. Results Univariate analysis showed that the medial bone type,bone mass,fractures reason, a fixed location,extent and reset after cortical distance were the main risk factors affecting the patient fixation failure. A significant factors were in-cluded in the Logistic regression model. The results showed that the type of fracture,bone mass,bone fixation failure reset extent the impact of hip fracture patients were the main risk factors. Among them,the fracture type is the biggest factor( OR = 5. 331). After fixation failure,patients were treated with total hip arthroplasty. The results showed that Harris score,pain score,walking score,score,activity scores were significantly higher compared with patients before surgery( P ﹤ 0. 05). Conclusion The type of fracture,bone mass,bone reset extent were the main risk factors for hip fracture patient fixation. Among them,the fracture type is the biggest factor(OR = 5. 331). After fixation failure in the patients with total hip arthroplasty for re - treatment can obtain satisfactory results.