导致桡骨远端骨折术后桡骨短缩的发生率及其危险因素分析

Incidence and risk factor analysis for postoperative shortening in distal radius fractures

目的探讨桡骨远端骨折术后出现短缩的危险因素,进而提出预防措施,提高桡骨远端骨折手术的疗效。方法将桡骨远端骨折174例作为研究对象,依据是否发生骨短缩分为短缩组和对照组,对桡骨远端骨折术后发生短缩的相关危险因素进行分析。结果 54例发生桡骨短缩(31.03%)。短缩组年龄≥60岁者比例明显高于对照组,短缩组合并骨质疏松者比例明显高于对照组,短缩组骨折类型为C型骨折者比例明显高于对照组,短缩组术中采用锁定加压接骨板内固定术患者数明显多于对照组,短缩组术中进行植骨患者数明显低于对照组,短缩组术后自主进行负荷锻炼患者比例明显高于对照组,差异均具有统计学意义(P<0.05)。术后负荷锻炼指导和AO分型作为独立影响因素对桡骨骨折术后桡骨短缩发生有显著影响(P<0.05)。结论桡骨远端关节内骨折术后桡骨短缩发生率较高。手术治疗时应对骨缩短的危险因素进行综合评估分析,并采取相应的防治措施,术后给予负荷锻炼指导,降低术后桡骨短缩的发生率。

Objective To analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and efficacy. Methods One hundred and seventy-four patients with distal radius fractures who were treated by surgical operation and followed up in the last four years in our hospital were involved. They were divided into radial shortening group and control group aeeording to the radial shortening status. The postoperative radial shortening was analyzed. Results Fifty-four patients were found radial shortening （31.03%）. The proportion of patients with age ~〉 60 in radial shortening group was higher than that in the control group. The proportion of osteoporosis patients in radial shortening group was higher than that in the control group. The proportion of type C fractures patients in radial shortening group was higher than that in the control group. The proportion of locking compression plate patients in radial shortening group was higher than that in the control group. The proportion of bone implant patients in radial shortening group was lower than that in the control group. The proportion of postoperative autonomous load exercise patients in radial shortening group was higher than that in the control group. These differences were all statistically significant （P 〈0.05）. Postoperative load exercise guidance and AO typing were independent prognostic factors for radial shortening in post operation. Conclusion There is a high incidence of radial shortening after operation for the intra-articular fractures of the distal radius, which affects the clinical results of operation. Therefore, we should pay more attention to the influencing factors and take corresponding precaution methods during operation, postoperative load exercise guidance to decrease the incidence of postoperative radial shortening.