胫骨平台骨折患者切开复位内固定术后发生膝关节僵硬的危险因素分析

Analysis of Risk Factors for Knee Joint Stiffness in Patients with Fracture of the Tibial Plateau after Open Reduction and Internal Fixation

目的:探究胫骨平台骨折(FTP)患者切开复位内固定术后发生膝关节僵硬的危险因素。方法:回顾性分析2019年2月—2021年6月宜春市中医院骨科收治的80例FTP患者的临床资料。患者均接受切开复位内固定术治疗且术后接受1年随访,统计患者术后随访期间的膝关节僵硬发生率。收集患者相关资料,将可能的影响因素纳入,分析FTP患者切开复位内固定术后发生膝关节僵硬的危险因素。结果:80例FTP患者中有12例发生膝关节僵硬,发生率为15.00%,有68例未发生膝关节僵硬,未发生率为85.00%。发生组合并伸膝装置损伤、石膏制动时间>60 d、无康复训练占比均高于未发生组,清创术次数多于未发生组(P<0.05);两组性别、年龄、手术时间、致伤原因比较,差异均无统计学意义(P>0.05)。经logistic回归分析显示,合并伸膝装置损伤、石膏制动时间>60 d、清创术次数较多、无康复训练是FTP患者切开复位内固定术后发生膝关节僵硬的危险因素(P<0.05)。结论:FTP患者切开复位内固定术后发生膝关节僵硬与合并伸膝装置损伤、石膏制动时间>60 d、清创术次数较多、无康复训练有关,临床可据此采取措施来预防膝关节僵硬。

Objective:To investigate the risk factors for knee joint stiffness in patients with fracture of the tibial plateau(FTP)after open reduction and internal fixation.Method:The clinical data of 80 FTP patients admitted to the orthopedics department of Yichun Hospital of Traditional Chinese Medicine from February 2019 to June 2021 were retrospectively analyzed.All patients were treated with open reduction and internal fixation and were followed up for 1 year.The incidence of knee joint stiffness during postoperative follow-up was analyzed.The risk factors of knee joint stiffness after open reduction and internal fixation in FTP patients were analyzed by collecting relevant data of patients and including possible influencing factors.Result:Among the 80 FTP patients,12 had knee joint stiffness(15.00%),and 68 had no knee joint stiffness(85.00%).The proportions of combined knee extension apparatus injury,plaster braking time>60 d,no rehabilitation training in the occurrence group were higher than those in the non-occurrence group,debridement times in the occurrence group was higher than that in the nonoccurrence group(P<0.05).There were no significant differences in gender,age,operation time and cause of injury between the two groups(P>0.05).logistic regression analysis showed that combined knee extension apparatus injury,plaster braking time>60 d,the more debridement times,and no rehabilitation training were the risk factors for knee joint stiffness after open reduction and internal fixation in FTP patients(P<0.05).Conclusion:Knee joint stiffness in FTP patients after open reduction and internal fixation is related to combined knee extension apparatus injury,plaster braking time>60 d,the more debridement times and no rehabilitation training.Therefore,clinical measures can be taken to prevent knee joint stiffness.