弹性髓内针治疗儿童胫骨干骨折临床疗效的Logistic分析

The Use of Elastic Stable Intramedullary Nail in the Treatment of Tibia Fracture in Children： a Logistic Regression Analysis

目的：探讨影响弹性髓内针治疗儿童胫骨干骨折临床疗效的相关因素。方法：回顾性分析2011年3月～2016年8月在我院骨科住院手术治疗的胫骨干骨折患儿144例，分析影响术后临床疗效的因素。根据Flynn髓内钉评价标准进行评估，将临床疗效分为观察及对照组2组。观察组127例，对照组17例。结果：单因素分析显示骨折类型（x2=3．91，P=0．048）、骨折部位（x2=5．04，P=0．025）、是否合并腓骨骨折（x2=8．715．P=0．003）和负重时间（x2=8．366，P=0．004）与术后临床疗效相关。非条件Logistic回归分析显示骨折部位（OR=2．35，P=0．029）及是否合并腓骨骨折（OR=4．83，P=0．003）是影响术后临床疗效的独立因素。结论：骨折部位及是否合并腓骨骨折是影响弹性髓内针治疗儿童胫骨干骨折临床疗效的主要因素。因此，胫骨干下1／3骨折和合算腓骨骨折患者增加捕助外固宕蠢．王正长固枣时闻以格高临廉浩井静粟．

Objective： To evaluate the clinical factors associated with the use of elastic stable intramedullary nail in the treatment of tibia fracture in children. Method： Totally 144 children with tibia fracture from March 2011 to August 2016 in Qiannan hospital of tradi- tional Chinese Medicine were analyzed retrospectively. 127 cases and 21 cases were in the superior and inferior group respectively accord- ing to Flynn（ a evaluation standard of intramedullary nailing）. Result： The single factor analysis showed that the type of fracture （x2 = 3. 91, P = 0.048 ）, the site of fracture （ x2 = 5.04, P = 0. 025 ）, with/without fibular fracture （ x2 = 8.715, P = 0. 003 ） and the time of burden （ x2 = 8. 366, P = 0. 004） were associated with the post - operative effect. Binary conditional logistic regression analysis showed that the site of fracture （ OR = 2.35, P = 0. 029 ） and with/without fibular fracture （ OR = 4.83, P = 0. 003 ） were independent factors for post - operative effect of tibia fracture in children. Conclusion ： The site of fracture and with/without fibular fracture are the main prognostic factors associ- ated with post -operative effect of tibia fracture in children. So, distal tibial fracture and/or with fibular fracture should be additional ex- ternal fixation and extended the time of fixation as to improve the effect of clinical treatment.