老年桡骨远端骨折患者经掌侧入路钢板内固定术后复位丢失情况及危险因素分析

Status and risk factors of reduction loss in elderly patients with distal radius fractures after plate internal fixation through a palmar approach

目的分析老年桡骨远端骨折患者经掌侧入路钢板内固定术后复位丢失情况及危险因素。方法回顾性分析2018年1月至2022年12月咸阳市第一人民医院收治的80例老年桡骨远端骨折患者病历资料。所有患者均接受经掌侧入路钢板内固定术治疗,依据患者术后是否出现复位丢失情况分组,采用单因素分析2组资料差异,采用多因素logistic回归分析术后复位丢失的影响因素。结果80例老年桡骨远端骨折患者中,依据复位成功标准,术后复位丢失患者24例(30.00%)纳入为复位丢失组,术后复位未丢失患者56例(70.00%)纳入复位成功组;2组患者年龄、骨折AO分型、骨折至接受手术时间、骨质疏松情况、桡骨远端至远端螺钉距离、术后功能锻炼开始时间比较,差异有统计学意义(P<0.05);经多因素logistic回归分析显示,年龄、骨折AO分型、骨折至接受手术时间、骨质疏松、桡骨远端至钢板远端螺钉距离均为老年桡骨远端骨折患者经掌侧入路钢板内固定术后复位丢失的影响因素(P<0.05)。结论老年桡骨远端骨折患者经掌侧入路钢板内固定术后复位丢失发生率较高,影响因素包括年龄、骨折AO分型、骨折至接受手术时间、骨质疏松、桡骨远端至钢板远端螺钉距离。

Objective To analyze the status and risk factors of reduction loss in elderly patients with distal radius fractures after plate internal fixation through a palmar approach.Methods Retrospective analysis of medical records of 80 elderly patients with distal radius fractures admitted to Xianyang First People′s Hospital from January 2018 to December 2022.The patients were grouped based on whether there was reduction loss after operation.Univariate analysis and multivariate logistic regression analysis were conducted to identify the influencing factors of postoperative reduction loss.Results Among the 80 elderly patients with distal radius fractures,there were 24(30.00%)patients with postoperative reduction loss and 56(70.00%)patients without.There were statistically significant differences between the two groups in terms of age,AO classification of fracture,time from fracture to operation,osteoporosis status,distance from distal radius to distal screw,and start time of postoperative exercise(P<0.05).Multivariate logistic regression analysis showed that age,AO classification of fracture,time from fracture to operation,osteoporosis,and distance from distal radius to distal screw were influencing factors of reduction loss in elderly patients with distal radius fractures after plate internal fixation through a palmar approach(P<0.05).Conclusions The incidence of reduction loss is relatively higher in elderly patients with distal radius fractures who have undergone plate internal fixation through a palmar approach.Age,AO classification of fracture,time from fracture to operation,osteoporosis,and distance from distal radius to distal screw are influencing factors of reduction loss.