高能量Pilon骨折手术疗效的影响因素分析

Analysis of influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture

目的探讨高能量Pilon骨折手术疗效的主要影响因素。方法回顾性分析41例高能量Pilon骨折患者的年龄、性别、学历、收入、骨折分型、手术时机、手术方式、骨折复位质量、术后并发症、术后功能锻炼时机与其术后Mazur踝关节功能评分间关系。结果 41例均获得回访,时间13～27(21.3±5.2)个月。并完成踝关节功能评价。单因素分析中,Mazur踝关节评分差异有统计学意义的影响因素为:年龄(P<0.05),学历(P<0.05),骨折分型(P<0.05),骨折复位质量(P<0.01),术后功能锻炼时机(P<0.01)。以患者年龄、学历、骨折分型、骨折复位质量、术后功能锻炼时机为自变量,以Mazur踝关节功能评分为因变量进行多元线性回归分析,最终骨折复位质量(X3)、骨折分型(X4)及术后功能锻炼时机(X5)3个自变量选入方程,回归方程为:Y=70.586+4.060X3-3.562X4+11.585X5。结论骨折分型、骨折复位质量、术后功能锻炼时机是高能量Pilon骨折术后踝关节功能主要影响因素。

Objective To explore the influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture.Methods A total of 41 patients with high-energy tibia Pilon fractures were retrospectively analyzed to reveal the relationship between age,gender,education,income,fracture types,surgery techniques,timing for surgery,quality of fracture reduction,complications,timing for postoperative functional exercise and Mazur ankle function score.Results All of them were followed up for 13~27（21.3±5.2） months after operation.In the sigle-factor analysis,the influencing factor of Mazur ankle function score with statistical significance were： age（P0.05）,education（P0.05）,fracture types（P0.05）,quality of fracture reduction（P0.01）,and timing for postoperative functional exercise（P0.01）.The parameters of the age,gender,education,income,fracture types,surgery techniques,timing for surgery,quality of fracture reduction,complications,timing for postoperative functional exercise of patients were analyzed to establish a statistic model by means of multiple linear regression,which showed that the P values of quality of fracture reduction（X3）,fracture type（X4）,timing for postoperative functional exercise（X5） were statistically significant（P0.05）.The regression equation was Y=70.586＋4.060X3-3.562X4＋11.585X5.Conclusions Quality of fracture reduction,fracture type,timing for postoperative functional exercise are the influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture.