胫骨平台骨折术后继发骨性关节炎的影响因素分析

Analysis of influencing factors of secondary osteoarthritis after operation of tibial plateau fracture

目的:探讨手术治疗胫骨平台骨折继发骨性关节炎(OA)的影响因素。方法:选择经手术治疗胫骨平台骨折病人79例,分为继发骨性关节炎组17例,非继发骨性关节炎组62例,单因素和logistic回归分析手术治疗胫骨平台骨折继发OA的危险因素。结果:2组性别、年龄、骨折分型(schatzker分型)、损伤暴力程度、吸烟与饮酒史、手术时间、出血量、植骨情况、住院总时间差异无统计学意义(P>0.05),围手术期时间差异有统计学意义(P<0.05)。Logistic回归分析显示,围手术期超过7 d是继发性OA发生危险因素。结论:围手术期的时间长度可以间接反映骨折吸收能量强度、软组织破坏情况,以及围手术对症处理的效果等综合情况,是术后继发OA的重要影响因素。

Objective:To explore the influencing factors of secondary osteoarthritis(OA)after operation of tibial plateau fracture.Methods:Seventy nine patients with tibial plateau fracture treated with operation were selected and divided into secondary OA group(n=17)and non-secondary OA group(n=62).The risk factors of secondary OA to surgical treatment of tibial plateau fracture were analyzed by single factor and logistic regression analysis.Results:There were no significant difference in gender,age,fracture classification(Schatzker type),degree of injury violence,smoking and drinking history,operation time,bleeding volume,bone grafting and total hospitalization days(P>0.05)between the two groups,but there was significant difference in perioperative days(P<0.05).Regression analysis showed that perioperative period of more than 7 days was a risk factor for secondary OA.Conclusions:The duration of perioperative period can indirectly reflect the energy absorption intensity of fracture,the destruction of soft tissue,and the effect of perioperative symptomatic treatment.It is an important influencing factor of postoperative secondary OA.