复杂胫骨平台骨折术后并发膝关节僵硬高危因素分析.docVIP

复杂胫骨平台骨折术后并发膝关节僵硬高危因素分析 　　[摘要] 目的 分析探讨手术治疗复杂胫骨平台骨折术后并发膝关节僵硬的高危因素。方法 方便选取2014年6月―2017年6月该院收治的复杂胫骨平台骨折患者60例，观察患者胫骨平台骨折情况，在手术治疗后，分析复杂胫骨平台骨折术后并发膝关节僵硬的高危因素。 结果 单因素分析结果显示，石膏制动时间小于4周，术后进行错误的康复指导和软组织缺乏分别产生膝关节僵硬的发病率为12例（52.2%）、9例（60.0%）、16例（41.1%）；多因素分析结果显示，合并膝关节周围初心多处损伤和膝关节周围异位骨化是患者术后并发膝关节僵硬的主要危险因素。结论 通过分析相关因素可以发现膝关节面复位质量、软组织周围损伤程度、术后镇痛、长时间的石膏制动、缺乏积极锻炼等是膝关节出现僵硬的重要危险因素，临床应当采取针对性干预措施，降低患者术后膝关节僵硬的发生风险。 　　[关键词] 复杂胫骨平台骨折；手术治疗；关节僵硬；高危因素 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）02（c）-0052-03 　　Analysis of High Risk Factors of Knee Stiffness after Fracture of Complicated Tibial Plateau 　　HOU Gang 　　Department of Orthopaedics， the Affiliated Hospital of Wulanchabu Medical College， Wulanchabu， Inner Mongolia， 012000 China 　　[Abstract] Objective This paper tries to explore the high risk factors for the complications of knee joint stiffness after surgical treatment of complicated tibial plateau fractures. Methods 60 cases of complex tibial plateau fractures in this hospital from June， 2014 to June， 2017 were convenient selected. The tibial plateau fractures were observed. After operation， the risk factors of knee joint stiffness after complicated tibial plateau fracture were analyzed. Results The univariate analysis showed that gypsum braking time of dess than 4 weeks， postoperative rehabilitation guidance error and soft tissue disease which caused the lack of knee stiffness with the rate was 12 case（52.2%）， 9 case60% and 16 case（41.1%） respectively； multi-factor analysis showed that the consolidation around the knee joint early heart multiple injuries and knee heterotopic ossification is a major risk knee joint ankylosis factors after surgery. Conclusion Through the analysis of relevant factors it can be found that the articular surface reduction， soft tissue damage， postoperative analgesia of long time， the lack of active exercise plaster are important risk factors of knee joint stiff， and it should be taken targeted interventions reducing the risk of knee joint stiffness