钢板内固定治疗跟骨关节内骨折患者预后的危险因素研究

Risk factors for prognosis of calcaneal intraarticular fracture treated by internal fixation with steel plate

目的探讨影响钢板内固定治疗跟骨关节内骨折患者预后的危险因素。方法选取2009年6月—2013年6月在该院接受钢板内固定治疗跟骨关节内骨折的患者90例。根据相关资料,对可能影响钢板内固定治疗跟骨关节内骨折患者预后的危险因素进行单因素方差分析和多因素Logistic回归分析,从而找出影响预后的危险因素。结果单因素分析结果表明,钢板内固定治疗跟骨关节内骨折术后疗效与体重、Sanders骨折分型、关节面塌陷程度和Bohler角四因素有关,而与性别、年龄、吸烟、手术时机和Gissane角无关。多因素分析结果表明,Sanders骨折分型、关节面塌陷程度和Bohler角三因素是钢板内固定治疗跟骨关节内骨折术后疗效的独立危险因素。结论影响钢板内固定治疗跟骨关节内骨折术后效果的危险因素主要有Sanders骨折分型、跟骨关节面塌陷程度和Bohler角,它们可作为判断跟骨关节内骨折预后的重要指标。

Objective To explore the risk factors for prognosis of calcaneal intraarticular fracture treated by internal fixation with steel plate. Methods Ninety cases of patients with calcaneal intraarticular fracture treated by internal fixation with steel plate in Wanbei General Hospital of Coal-electricity Group between June 2009 and June 2013 were selected. According to the relevant information of patients,the possible risk factors were analyzed by the methods of both univariate analysis and multivariate analysis. Results Univariate analysis showed that the prognosis was related to weight,the Sanders Fracture classification,the distance of articular surface collapsing,and the Bohler angle,while not related with sex,age,smoking,time of operation,and Gissane angle. Multivariate analysis showed that 3factors were independent risk factors,including the Sanders fracture classification,the distance of articular surface collapsing,and the Bohler angle. Conclusions The Sanders fracture classification,the distance of articular surface collapsing,and the Bohler angle are independent risk factors for prognosis of calcaneal intraarticular fracture treated by internal fixation with steel plate,which can be important indicators of the prognosis.