膝关节骨折患者术后膝关节功能恢复的影响因素分析

Analysis of the factors influencing postoperative recovery of knee joint function in patients with knee fractures

目的分析影响膝关节骨折术后患者膝关节功能恢复的因素,为促进患者术后康复提供依据。方法回顾性分析107例膝关节骨折患者的临床资料,术后随访1年。根据HSS评分将患者分为恢复理想组(HSS评分≥66分)和恢复不理想组(HSS评分<66分),采用二元Logistic回归分析膝关节骨折术后膝关节功能恢复的影响因素。结果单因素分析结果表明,膝关节功能恢复理想组与不理想组的性别、体质量指数、吸烟史、骨折类型、骨折部位、受伤至手术时间、功能锻炼开始时间比较,差异无统计学意义(P>0.05),两组的年龄、是否患糖尿病、复位质量、CPM功能锻炼、术后并发症比较,差异具有统计学意义(P<0.05)。Logistic回归分析结果表明,年龄大、糖尿病、非解剖复位、术后并发症是膝关节骨折术后膝关节功能恢复的危险因素(P<0.05),CPM功能训练是膝关节骨折术后膝关节功能恢复的保护因素(P<0.05)。同一骨折类型不同分型患者之间的膝关节功能恢复情况差异有统计学意义(P<0.05)。结论年龄、糖尿病、复位质量、CPM功能训练、术后并发症及骨折损伤程度,是膝关节骨折术后患者膝关节功能恢复的主要影响因素。

Objective To analyze the factors affecting the recovery of knee joint function in patients with knee joint fractures after surgery,and to provide references for promoting the rehabilitation of patients after surgery.Methods The clinical data of 107 patients with knee joint fractures were retrospectively analyzed,and a 1-year follow-up was conducted after the operation.Patients were divided into ideal recovery group(HSS score≥66)and poor recovery group(HSS score<66)according to the HSS score.Binary Logistic regression was used to analyze the factors affecting the recovery of knee joint function after knee fracture operation.Results The results of univariate analysis showed that there were no statistically significant differences in gender,body mass index,smoking history,fracture type,fracture site,the time from injury to operation and the starting time of functional exercise between the ideal recovery group and the poor recovery group(P>0.05),and there were statistically significant differences in age,diabetes,reduction quality,CPM functional exercise and postoperative complications between the two groups(P<0.05).The results of Logistic regression analysis showed that older age,diabetes,non-anatomical reduction and postoperative complications were risk factors for the recovery of knee function after knee fracture surgery(P<0.05),and CPM function training was a protective factor for the recovery of knee function after knee fracture surgery(P<0.05).There were statistically significant differences in the recovery of knee joint function among patients with different fracture types of the same fracture(P<0.05).Conclusions Age,diabetes,reduction quality,CPM function training,postoperative complications and severity of injury are the main influencing factors of the recovery of knee joint function after knee joint fracture operation.