影响胫腓骨开放性骨折愈合的多因素分析

Multi-factors analysis on the healing of open fracture of tibia and fibula

[目的]探讨影响胫腓骨开放性骨折愈合的主要因素。[方法]回顾性分析本院从2005年5月～2010年2月5年间收治的81例胫腓骨开放性骨折的病历资料。采用单因素分析患者年龄、性别、致伤原因、合并伤、骨折肢别、骨折分型、从受伤至开始清创的时间、固定方式、软组织修复时机、VSD的应用等10项因素与骨折愈合率的关系,对以上有意义的因素进行二分类的多因素Logistic回归分析。[结果]单因素分析结果,可能影响胫腓骨开放性骨折愈合的因素有致伤原因、骨折分型、从受伤至开始清创的时间及软组织修复时机等4个因素,多因素Lo-gistic回归分析发现致伤原因、骨折分型以及软组织修复时机与胫腓骨开放性骨折愈合独立相关,其他因素没有统计学意义。[结论]高能量损伤是影响胫腓骨开放性骨折愈合的危险因素,胫腓骨开放性骨折的愈合率与骨折分型严重程度有关,早期软组织修复有利于胫腓骨开放性骨折愈合。

[Objective] To discuss the main factors affecting the healing of open fracture of tibia and fibula. [Method] Retrospective analysis of our hospital from May 2005 to February 2010,81 cases of treated open fractures of tibia and fibula information were gathered. Univariate logistic regression analysis were used including patients age, sex, cause of injury, associated injuries, fractures of other limbs, fracture type, the time from injury to debridement, fixation, the timing of the soft tissue closure, and the application of VSD etc. Above 10 factors were analyzed on the relationship to the healing rate. The binary logistic regression analysis of multiple factors was carried out. [Result] Univariate logistic regression revealed that causes of injury,fracture type, the time from injury to debridement, and the timing of the soft tissue closure were correlated with the healing rate of open fracture of tibia and fibula. Logistic regression analysis of multiple factors revealed that causes of injury, fracture type and the timing of the soft tissue closure were associated independently with the healing of open fracture of tibia and fibula,while the other factors were not statistically significant. [Conclusion] High-energy injuries is the risk factor of affecting healing of open fracture of tibia and fibula. There is a connection between the type and severity offracture to the healing rate of open fractures of tibia and fibula. Early repair of soft tissue does have a benefit in the healing of open fractures of tibia and fibula.