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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第26卷

期數(shù):

2014年11期

頁碼:

17-19

欄目:

臨床研究

出版日期:

2014-11-30

文章信息/Info

Title:

Study on relevant factors of humeral shaft fracture delayed union and disunion

作者:

周勇; 熊小天; 徐祖健

瀘州醫(yī)學院附屬中醫(yī)醫(yī)院,四川 瀘州 646000

Author(s):

Zhou Yong^*; Xiong Xiaotian; Xu Zujian.^*

The affiliated hospital of traditional Chinese medicine of Luzhou medical school,Luzhou 646000,Sichuan,China

關(guān)鍵詞:

肱骨骨折 骨折; 不愈合

Keywords:

Humeral fractures;  Fractures; ununited

摘要:

目的:探討導致肱骨干骨折延遲愈合及不愈合的相關(guān)因素。方法:回顧性分析93例肱骨干骨折患者的病例資料,其中31例肱 骨干骨折延遲愈合及不愈合患者納入觀察組,62例肱骨干骨折骨性愈合患者納入對照組。比較2組患者的骨折粉碎、骨折端軟組 織損傷、骨折復位、固定不穩(wěn)、感染及不合理功能活動情況。結(jié)果:觀察組中23例為嚴重粉碎性骨折患者,對照組中26例為嚴重 粉碎性骨折患者; 觀察組中嚴重粉碎性骨折患者的比例大于對照組(χ²=8.627,P=0.003); 其相對危險度是對照組 的3.981倍。觀察組中固定不穩(wěn)25例,對照組中固定不穩(wěn)13例; 觀察組中固定不穩(wěn)患者的比例大于對照組 (χ²=30.459,P=0.000); 其相對危險度是對照組的15.705倍。觀察組中不合理功能活動患者26例,對照組中12例; 觀察組中不合理功能活動患者的比例大于對照組(χ²=35.598,P=0.000); 其相對危險度是對照組的21.667倍。觀察 組在骨折端軟組織損傷情況、骨折復位和感染三方面與對照組相比,組間差異均無統(tǒng)計學意義(χ²=1.902,P=0.168; χ²=0.939,P=0.332; χ²=0.661,P=0.416)。結(jié)論:肱骨干骨折后發(fā)生延遲愈合及不愈合主要與不合理 的功能活動、固定不穩(wěn)及嚴重粉碎性骨折有關(guān)聯(lián),但骨折延遲愈合及不愈合的發(fā)生絕不是單一因素作用的結(jié)果,而是混雜了多種 因素的交叉作用結(jié)果。對于各因素間有無交互效應及其相關(guān)性,我們將繼續(xù)收集資料做進一步分析研究。

Abstract:

Objective:To explore the relevant factors of humeral shaft fracture delayed union and disunion.Methods:The medical records of 93 patients with humeral shaft fracture were analyzed retrospectively.Thirty-one patients with humeral shaft fracture delayed union and disunion were recruited into the observation group,while 62 patients with humeral shaft fracture bone union were recruited into the control group.Then the two groups were compared with each other in degree of fracture comminution,soft tissue injury around broken ends of fractured bone,fracture reduction,fixation instability,infection and unreasonable functional activities.Results:Twenty-three patients were diagnosed as severe comminuted fracture in observation group,while 26 patients were diagnosed as severe comminuted fracture in control group.The proportion of patients with severe comminuted fracture was larger in observation group compared to control group (χ²=8.627,P=0.003),and the relative risk of severe comminuted fracture of observation group was 3.981 times of that of control group.There were 25 patients with fixation instability in observation group,while 13 patients in control group.The proportion of patients with fixation instability was larger in observation group compared to control group(χ²=30.459,P=0.000),and the relative risk of observation group was 15.705 times of that of control group.There were 26 patients with unreasonable functional activities in observation group,while 12 patients in control group.The proportion of patients with unreasonable functional activities was larger in observation group compared to control group(χ²=35.598,P=0.000),and the relative risk of observation group was 21.667 times of that of control group.There was no statistical difference in degree of soft tissue injury around broken ends of fractured bone,fracture reduction and infection between the 2 groups(χ²=1.902,P=0.168; χ²=0.939,P=0.332; χ²=0.661,P=0.416).Conclusion:The humeral shaft fracture delayed union and disunion are mainly associated with unreasonable functional activities,fixation instability and severe comminuted fractures.However,multiple factors but not single factor lead to humeral shaft fracture delayed union and disunion.Further study is needed to make clear whether there are any interaction effects and correlations between various factors.

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備注/Memo:

通訊作者:徐祖健 E-mail:[email protected]

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更新日期/Last Update: 2014-11-30