股骨髁部支撑钢板对股骨远端骨折手术疗效的影响因素分析

Analysis of related factors affecting in condylar buttress plate surgical treatment of distal femoral fractures

目的 分析股骨髁部支撑钢板（CBP）对股骨远端骨折手术疗效的影响因素.方法 将100例股骨远端骨折患者分别根据可能影响CBP治疗股骨远端骨折的8个相关因素（性别、年龄、骨折类型、骨折分类、手术时机、复位质量、是否植骨、是否行石膏制动）分组,按Neer膝关节功能评分表对手术疗效评分,评分≥72分为优良,＜72分为非优良.先分别对8个相关因素的手术疗效进行单因素分析,行x2检验,再将P＜0.05的相关因素进行Logistic多因素回归分析,探讨采用CBP治疗股骨远端骨折的独立危险因素.结果 男性组与女性组,开放性骨折组与闭合性骨折组术后优良率的差异均无统计学意义（P＞0.05）;青年组、中年组与老年组,A型骨折组与C型骨折组术后优良率的差异均有统计学意义（P＜0.05）;在7d内手术的患者明显比7d后手术的术后疗效好（P＜0.05）;术中未植骨比术中植骨的术后疗效更好（P＜0.05）;复位满意组和未行石膏制动组的术后疗效分别明显优于复位不满意组和行石膏制动组（P＜0.05）.Logistic多因素回归分析结果显示,年龄（OR=12.864）、骨折类型（OR=47.597）和复位质量（OR=1 1.549）是影响手术疗效的独立危险因素.结论 年龄、骨折类型和复位质量是影响CBP治疗股骨远端骨折手术疗效的独立危险因素,这将为提高CBP治疗股骨远端骨折手术疗效提供一定的参考.

Objective To analyze of related factors in affecting condylar buttress plate （CBP） surgical treatment of distal femoral fractures.Methods One hundred patients with distal femoral fractures were grouped according to eight related factors （gender,age,fracture type,fracture classification,surgical time,reset quality,whether bone graft and plaster braking）,respectively.Operative efficacy was scored by the Neer knee functional score table,and score ≥ 72 was excellent,while ＜ 72 was good.Eight related factors were carried out single factor analysis with x2 test to compare the operative efficacy of each group,then the related factors with single factor analysis result of P＜0.05 were put in Logistic multifactor regression analysis,in order to clarify the independent risk factors for CBP treatment of distal femoral fractures.Results There was no significant difference （P＞0.05） in the operative efficacy between male and female group,open fracture and closed fracture group.The difference between youth,middle-aged and elderly group,type A and type C fracture group was statistically significant （P＜0.05）.The operative efficacy of patients got surgery within 7 d was obviously better than those who got surgery 7 d later （P＜0.05）.The operative efficacy of patients who had no intraoperative bone graft was better than those who had bone graft （P＜0.05）.The operative efficacy of satisfactory reset group and none plaster braking group was better than that of unsatisfied reset group and plaster braking group （P＜0.05）,respectively.Conclusions Age,fracture type and reset quality are CBP therapy independent risk factors for the efficacy of operation for patients with distal femoral fractures,which will provide some reference for improving the operative efficacy of CBP operation in treatment of distal femoral fractures.