老年股骨远端骨折内固定患者术后骨折不愈合的相关因素分析

Analysis of Related Factors of Postoperative Fracture Nonunion in Elderly Patients with Distal Femoral Fracture Internal Fixation

目的:分析老年股骨远端骨折内固定患者术后骨折不愈合的相关因素。方法:选取2019年2月—2022年6月武汉市新洲区中医骨伤专科医院收治的102例老年股骨远端骨折内固定患者为研究对象。所有患者均进行常规锁定钢板内固定治疗。调查所有患者的一般资料,测定所有患者骨密度、25羟维生素D3水平。对所有患者进行1年随访。分析所有患者骨折愈合情况。比较骨折愈合患者及骨折不愈合患者一般资料、骨密度、25羟维生素D_(3)。分析老年股骨远端骨折内固定患者术后骨折不愈合的影响因素。结果:102例患者中,骨折愈合79例,骨折不愈合23例。骨折不愈合患者延迟负重、骨量异常、25羟维生素D3异常占比均高于骨折愈合患者,差异有统计学意义(P<0.05)。延迟负重、骨量异常、25羟维生素D3异常为诱发老年股骨远端骨折内固定术后骨折不愈合的因素(P<0.05)。结论:影响老年股骨远端骨折内固定患者术后骨折不愈合的因素包括延迟负重、骨密度、25羟维生素D3,对于存在此类因素的患者应在术后加强监测,以防发生骨折不愈合。

Objective:To analyze the related factors of postoperative fracture nonunion in elderly patients with distal femoral fracture internal fixation.Method:A total of 102 elderly patients with internal fixation of distal femoral fracture admitted to Wuhan Xinzhou District Specialty Hospital of Department of Orthopedics and Traumatology of Traditional Chinese from February 2019 to June 2022 were selected as the study objects.All patients underwent conventional locking plate internal fixation treatment.The general data of all patients were investigated and bone mineral density and 25 hydroxyvitamin D3 levels were determined.All patients were followed up for 1 year.Fracture healing condition of all patients was analyzed.The general data,bone mineral density and 25 hydroxyvitamin D_(3) were compared between patients with fracture healing and those with fracture nonunion.The influencing factors of postoperative fracture nonunion in elderly patients with distal femoral fracture internal fixation was analyzed.Result:Of the 102 patients,79 were fracture union and 23 were fracture nonunion.The proportion of delayed weight bearing,abnormal bone mass and abnormal 25 hydroxyvitamin D3 in patients with nonunion were higher than those with union,and the differences were statistically significant(P<0.05).Delayed weight bearing,abnormal bone mass and abnormal 25 hydroxyvitamin D3 were the factors that induced fracture nonunion after internal fixation of distal femoral fracture in elderly patients(P<0.05).Conclusion:Factors affecting postoperative fracture nonunion in elderly patients with internal fixation of distal femur fracture include delayed weight bearing,bone mineral density,and 25 hydroxyvitamin D3.Patients with such factors should be closely monitored after surgery to prevent fracture nonunion.