| 肱骨髁间骨折内固定术后肘关节僵硬的危险因素探讨 |
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投稿时间：2022-02-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 吴长青 |
WU Chang-qing |
第九五一医院创伤骨科, 新疆维吾尔自治区 库尔勒 841000 |
Department of Orthopaedics and Traumatology, No. 951 Hospital, Korla 841000, Xinjiang Uygur Zizhiqu, China |
pengyou786@163.com |
| 华英 |
HUA Ying |
第九五一医院创伤骨科, 新疆维吾尔自治区 库尔勒 841000 |
Department of Orthopaedics and Traumatology, No. 951 Hospital, Korla 841000, Xinjiang Uygur Zizhiqu, China |
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| 刘勇占 |
LIU Yong-zhan |
第九五一医院创伤骨科, 新疆维吾尔自治区 库尔勒 841000 |
Department of Orthopaedics and Traumatology, No. 951 Hospital, Korla 841000, Xinjiang Uygur Zizhiqu, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第7期，第614-618页 |
| DOI：10.12200/j.issn.1003-0034.2023.07.004 |
| 基金项目: |
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中文摘要:
目的：探讨肱骨髁间骨折内固定术后发生肘关节僵硬的危险因素。
方法：自2015年3月至2019年2月采用切开固定术治疗120例肱骨髁间骨折患者，男59例，女61例，年龄25~77（53.5±3.2）岁。根据术后是否发生肘关节僵硬分为僵硬组37例和对照组83例，采用单因素分析发生肘关节僵硬的相关因素，Logistic回归分析肱骨髁间骨折内固定术后发生肘关节僵硬的危险因素。
结果：所有患者至末次随访时发生肘关节僵硬37例（僵硬组），未发生肘关节僵硬83例（对照组），关节僵硬发生率为30.83%，僵硬组与对照组在年龄、损伤能量、合并其他部位骨折、骨折至手术时间、骨折AO分型、是否开放性损伤和术后过早或过度活动等方面比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析显示年龄>50岁、高能量损伤、骨折AO分型、开放性骨折和术后过早或过度活动是肱骨髁间骨折内固定术后肘关节僵硬的危险因素。术后僵硬组术后活动度以及Mayo肘关节功能评分均低于术后非僵硬组，差异有统计学意义（P<0.05）。肱骨髁间骨折术后肘关节屈曲僵硬与旋转僵硬患者的术后活动度以及Mayo评分比较，差异均无统计学意义（P>0.05）。
结论：针对肱骨髁间骨折内固定术后肘关节僵硬的危险因素，术前应制定合理的手术方案和康复策略，以最大程度降低肘关节僵硬的发生率。 |
| 【关键词】肱骨髁间骨折 切开复位 内固定术 关节僵硬 肘关节 风险因素 |
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| Risk factors of elbow stiffness after open reduction and internal fixation of intercondylar fracture of humerus |
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ABSTRACT
Objective To investigate the risk factors of elbow stiffness after open reduction and internal fixation of intercondylar fracture of humerus.
Methods From March 2015 to February 2019, 120 patients with humeral intercondylar fractures were treated with open fixation including 59 males and 61 females, aged from 25 to 77 years with an average of(53.5±3.2) years. According to the occurrence of elbow stiffness after operation, 120 patients were divided into stiffness group(37 cases) and control group(83 cases). The related factors of elbow stiffness were analyzed by single factor analysis, and the risk of elbow stiffness after internal fixation of humeral intercondylar fracture was analyzed by logistic regression factor.
Results There were 37 cases of elbow stiffness(stiff group), and 83 cases had no elbow stiffness(control group). The incidence of joint stiffness was 30.83%. There were significant differences between the stiffness group and the control group in age, injury energy, fracture to operation time, AO classification of fracture, open injury and postoperative premature or hyperactivity. Multivariate logistic regression analysis showed that age>50 years old, high energy injury, AO classification of fracture, open fracture and postoperative premature or hyperactivity were risk factors for elbow stiffness after internal fixation of humeral intercondylar fracture. The postoperative mobility and Mayo elbow performance score(MEPS) scores of the postoperative stiffness group were lower than those of the non-stiffness group with statistical significance(P<0.05). There were no significant differences in postoperative mobility and MEPS scores between flexion stiffness and rotation stiffness after humeral intercondylar fracture(P>0.05).
Conclusion In view of the risk factors of elbow stiffness after internal fixation of humeral intercondylar fracture, reasonable operation plan and rehabilitation strategy should be formulated before operation to minimize the incidence of elbow stiffness. |
| KEY WORDS Humeral intercondylar fracture Open reduction Internal fixation Joint stiffness Elbow joint Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴长青,华英,刘勇占.肱骨髁间骨折内固定术后肘关节僵硬的危险因素探讨[J].中国骨伤,2023,36(7):614~618 |
| 英文格式: | WU Chang-qing,HUA Ying,LIU Yong-zhan.Risk factors of elbow stiffness after open reduction and internal fixation of intercondylar fracture of humerus[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(7):614~618 |
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