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[1]莫軍杰,孫奇,周君鵬,等.老年伸直型橈骨遠(yuǎn)端骨折手法復(fù)位夾板外固定治療后骨折移位的危險(xiǎn)因素分析[J].中醫(yī)正骨,2021,33(08):12-15.
　MO Junjie,SUN Qi,ZHOU Junpeng,et al.Analysis of risk factors for fracture displacement after manipulative reduction and splint external fixation for treatment of straighten distal radius fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(08):12-15.
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老年伸直型橈骨遠(yuǎn)端骨折手法復(fù)位夾板外固定治療后骨折移位的危險(xiǎn)因素分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年08期
頁碼:
12-15
欄目:
臨床研究
出版日期:
2021-08-20

文章信息/Info

Title:
Analysis of risk factors for fracture displacement after manipulative reduction and splint external fixation for treatment of straighten distal radius fractures in the aged
作者:
莫軍杰; 孫奇; 周君鵬; 裘曉東; 孫曉; 陳金洪; 張玉良
(杭州市富陽中醫(yī)骨傷醫(yī)院,浙江 杭州 311400)
Author(s):
MO Junjie; SUN Qi; ZHOU Junpeng; QIU Xiaodong; SUN Xiao; CHEN Jinhong; ZHANG Yuliang
Fuyang TCM Orthopedic-Traumatological Hospital,Hangzhou 311400,Zhejiang,China
關(guān)鍵詞:
Colles骨折;  正骨手法;  小夾板固定;  危險(xiǎn)因素;  Logistic模型
Keywords:
Colles’ fracture;  bone setting manipulation;  small splint fixation;  risk factors;  logistic models
摘要:
目的:探討老年伸直型橈骨遠(yuǎn)端骨折手法復(fù)位夾板外固定治療后骨折移位的危險(xiǎn)因素。方法:選擇298例采用手法復(fù)位夾板外固定治療的老年伸直型橈骨遠(yuǎn)端骨折患者,從病歷系統(tǒng)中提取性別、就診年齡、受傷至就診時(shí)間、患側(cè)是否為利手側(cè)、治療前橈骨短縮程度和掌傾角、橈骨遠(yuǎn)端背側(cè)是否粉碎、是否合并尺骨莖突骨折、固定后患肢是否懸吊、是否聯(lián)合口服中藥治療、外固定時(shí)間及骨折移位情況等信息。按照骨折移位情況將患者分為移位組和未移位組,先對2組患者的相關(guān)信息進(jìn)行單因素分析,然后對篩選出的因素進(jìn)行Logistic多因素回歸分析。結(jié)果:移位組60例,未移位組238例。2組患者的性別、患側(cè)為利手側(cè)、橈骨短縮、掌傾角、橈骨遠(yuǎn)端背側(cè)粉碎、尺骨莖突骨折情況比較,組間差異均有統(tǒng)計(jì)學(xué)意義(χ2=20.560,P=0.000; χ2=4.387,P=0.036; t=-6.650,P=0.000; t=3.423,P=0.001; χ2=65.971,P=0.000; χ2=117.720,P=0.000); 2組患者的年齡、受傷至就診時(shí)間、患肢懸吊、外固定時(shí)間及口服中藥治療情況比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.610,P=0.542; χ2=0.614,P=0.433; χ2=0.007,P=0.931; χ2=0.308,P=0.579; χ2=0.088,P=0.767)。Logistic多因素回歸分析顯示,性別、橈骨短縮、橈骨遠(yuǎn)端背側(cè)粉碎、尺骨莖突骨折均為老年伸直型橈骨遠(yuǎn)端骨折手法復(fù)位夾板外固定治療后骨折移位的危險(xiǎn)因素(P=0.018,OR=3.634; P=0.039,OR=1.369; P=0.000,OR=5.167; P=0.000,OR=13.763)。結(jié)論:性別、橈骨短縮、橈骨遠(yuǎn)端背側(cè)粉碎、尺骨莖突骨折是老年伸直型橈骨遠(yuǎn)端骨折手法復(fù)位夾板外固定治療后骨折移位的危險(xiǎn)因素。
Abstract:
Objective:To explore the risk factors for fracture displacement in the aged patients who undergo manipulative reduction and splint external fixation for treatment of straighten distal radius fractures(DRFs).Methods:Two hundred and ninety-eight aged patients who underwent manipulative reduction and splint external fixation for treatment of straighten DRFs were selected,and their information about gender,age,time from injury to visiting,the affected side in handedness side or not,pretreatment radial shortening degree and volar tilt angle,distal radius fractures(DRFs)with dorsal comminution or not,combining with ulnar styloid fractures(USFs)or not,suspension of the affected limbs or not after fixation,treatment with oral application of TCM or not,external fixation time and fracture displacement were extracted from the electronic medical record system(EMRS)for analysis.All patients were divided into the displaced group(60 cases)and undisplaced group(238 cases)according to whether the fracture displacement happened after manipulative reduction and splint external fixation.The single-factor analysis was conducted on the extracted information for screening the risk factors affecting fracture displacement,followed by logistic multi-factor regression analysis on the screened risk factors.Results:There was statistical difference in gender,affected side in handedness side,radial shortening,volar tilt angle,dorsally comminuted DRFs,USFs between the 2 groups(χ2=20.560,P=0.000; χ2=4.387,P=0.036; t=-6.650,P=0.000; t=3.423,P=0.001; χ2=65.971,P=0.000; χ2=117.720,P=0.000); while there was no statistical difference in age,time from injury to visiting,suspension of affected limb,external fixation time and oral application of TCM between the 2 groups(t=0.610,P=0.542; χ2=0.614,P=0.433; χ2=0.007,P=0.931; χ2=0.308,P=0.579; χ2=0.088,P=0.767).The results of logistic multi-factor regression analysis revealed that the gender,radial shortening,dorsally comminuted DRFs and USFs were the risk factors for fracture displacement in the aged patients who underwent manipulative reduction and splint external fixation for straighten DRFs(P=0.018,OR=3.634; P=0.039,OR=1.369; P=0.000,OR=5.167; P=0.000,OR=13.763).Conclusion:The gender,radial shortening,dorsally comminuted DRFs and USFs are the risk factors for fracture displacement in the aged patients who undergo manipulative reduction and splint external fixation for straighten DRFs

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備注/Memo

備注/Memo:
基金項(xiàng)目:杭州市科技計(jì)劃引導(dǎo)項(xiàng)目(20181228Y146)
通訊作者:孫奇 E-mail:[email protected]
更新日期/Last Update: 1900-01-01