四肢骨折普通钢板内固定取出的手术风险分析

Analysis of the risk of removal of internal fixation with common plate for fracture of extremities

目的:探讨四肢骨折普通钢板内固定取出的手术风险。方法:回顾性分析2015年1月至2018年1月取出四肢骨折普通钢板内固定患者190例临床资料,根据患者的疗效情况分为两组,即优良组、效果差和失败组,单因素及Logisitic回归分析四肢骨折普通钢板内固定取出手术的影响因素。结果:190例内固定取出患者效果为优的有93例(48.94%),良65例(34.21%),差22例(11.58%),失败10例(6.33%),优良率为83.16%(158/190);单因素分析显示BMI指数、年龄、骨折AO分型、螺柱直径、骨质疏松、内科疾病是四肢骨折普通内固定取出术疗效不佳的影响因素(P<0.05);多因素Logisitic回归分析显示,骨质疏松及高AO分型是四肢骨折普通钢板内固定取出术疗效不好的危险性因素;螺柱大直径是保护性因素(P<0.05)。结论:骨质疏松及高AO分型是四肢骨折普通钢板内固定取出术疗效不佳的危险性因素;螺钉大直径是保护性因素。

Objective:To investigate the risk of removal of internal fixation with common plate for extremities fracture.Methods:The clinical data of 190 patients with internal fixation of common plate for extremities fracture from January 2015 to January 2018 were analyzed retrospectively.According to the curative effect,the patients were divided into two groups,excellent group and poor failure group.Univariate analysis and Logisitic regression analysis were used in analyzing the influencing factors in removal of internal fixation with common plate for extremities fracture.Results:In 190 cases of removal of internal fixation,there were 93 cases with excellent effect(48.94%),65 cases with good effect(34.21%),22 cases of poor(11.58%),and 10 cases of failure(6.33%),and the excellent and good rate was 83.16%(158/190).Univariate analysis showed that BMI index,age,AO classification of fracture,diameter of stud,osteoporosis,the internal diseases were the influencing factors of the poor curative effect of common internal fixation for extremities fracture(P<0.05);the multiple-factor Logisitic regression analysis showed that osteoporosis and high AO classification were the risk factors of poor curative effect of internal fixation with common plate fixation for extremities fracture;the large diameter of stud was the protective factor.Conclusion:Osteoporosis and high AO classification are the risk factors for the poor curative effect of internal fixation with common plate fixation for extremities fracture,and the large diameter of stud is the protective factor.