成人桡骨远端骨折保守治疗后桡骨短缩的危险因素

摘要

Objective:To analyze the of risk factors of radius shortening in adult with distal radius fracture after conservative treatment by Logistic analysis.Methods:From May 2009 to March 2015,137 adults patients with distal radius fracture treated by conservative treatment were retrospective analyzed,and 36 patients occurred radius shortening,including 7 males and 29 females with an average age of (58.33±14.06) years old,8 patients were type A,34 patients were type B and 12 patients were type C according to fracture classification;101 patients were without radius shortening,including 23 males and 78 females with an average age of (52.49± 12.79) years old,48 patients were type A,34 patients were type B and 19 patients were type C according to fracture classification.Ages,gender,BMI,time from injuries to reduction,fracture classification,fixed form and loading time were collected and screened risk factors by Logistic analysis.Results:All patients were followed up from 8 to 16 months.Ages,time from injuries to reduction,fracture classification,earlier loading could obviously affect radius shortening by univariate analysis,multivariate logistic analysis revealed the risk factor including ages [OR=1.045 (1.008-1.083),P=-0.015],time from injury to reduction [OR=2.853 (1.178-6.909),P=0.020],fracture classification (Type C fracture was more relevant to radius shortening than other two type fractures) [OR =4.854 (1.506-15.640),P=0.008],and earlier loading [OR=3.038 (1.138-8.111),P=0.027].Conclusion:Ages,time from injury to reduction,fracture classification,and earlier load are the risk factors of radius shortening,so corresponding preventive measures and appropriate treatment should be applied to according to different risk factor.%目的:通过Logistic回归分析成人桡骨远端骨折保守治疗后桡骨短缩的危险因素,从而提出相关预防措施.方法:回顾性分析2009年5月至2015年3月于我院行保守治疗的成人桡骨远端骨折,经筛选后符合要求的共137例,其中发生桡骨短缩36例,男7例,女29例;平均年龄(58.33±14.06)岁;骨折类型:A型8例,B型16例,C型12型.无明显短缩101例,男23例,女78例;平均年龄(52.49±12.79)岁;骨折类型:A型48例,B型34例,C型19型.对以上病例,收集其年龄、性别、BMI、受伤至复位时间、骨折类型、固定方式、负荷时间等资料,采用Logistic回归分析方法筛选出桡骨短缩的危险因素.结果:所有病例均获得随访,时间8～16个月.单因素分析显示年龄、受伤至复位时间、骨折类型、过早负荷对桡骨短缩的发生有显著影响;多因素Logistic回归分析显示成人桡骨远端骨折保守治疗后桡骨短缩的危险因素分别是年龄[OR=1.045(1.008-1.083),P=0.015],受伤至复位时间[OR=2.853(1.178-6.909),P=0.020],骨折类型(C型骨折较其他两型骨折更易导致桡骨短缩)[OR=4.854(1.506-15.640),P=0.008],过早负荷[OR:3.038(1.138-8.111),P=0.027].结论:成人桡骨远端骨折保守治疗后桡骨短缩的危险因素为年龄、受伤至复位时间、骨折类型、过早负荷,应根据不同危险因素采取相应的预防处理措施及选择合适的治疗方法.