高能量Pilon骨折手术疗效影响因素分析.docVIP

高能量Pilon骨折手术疗效影响因素分析 　　[摘要] 目的 分析高能量Pilon骨折手术疗效的影响因素。方法 方便选取2010年1月―2015年10月，山西省荣军医院治疗高能量Pilon骨折患者107例，恢复优良患者50例纳入优良组（Mazur踝关节评分≥87分），其余57例患者纳入对照组，进行因素分析。结果 患者末次随访Mazur踝关节评分（85.6±7.3）分；优良组Ⅲ-Ⅳ型、严重软组织缺损、大专及以上文化水平、延迟ORIF、中药外治、功能训练依从性好分别占34.00%、4.00%、34.00%、90.00%、54.00%、90.00%，对照组则为63.16%、24.56%、12.28%、57.89%、35.09%、66.67%，差异有统计学意义（P0.05）；延迟ORIF[OR=1.485，95%CI（1.189～10.763）]、功能锻炼依从性好[OR=1.310，95%CI（1.278～5.115）]成为保护因素，也是可控因素。结论 需科学的安排功能训练。 　　[关键词] Pilon骨折；手术疗效；高能量创伤；影响因素分析 　　[中图分类号] R683 [文献标识码] A [文章编号] 1674-0742（2017）03（b）-0086-03 　　[Abstract] Objective To analyze the influence factors of curative effect of high energy Pilon fracture surgery. Methods 107 cases of patients with high energy Pilon fracture surgery treated in our hospital from January 2010 to October 2015 were conveniently selected and divided into two groups， 50 cases of patients whose recovery was excellent and good （Mazur ankle joint score ≥87 points） were selected as the excellent and good group， while 57 cases of patients were include into the control group and were given the factor analysis. Results The final follow-up Mazur ankle joint score of patients was（85.6±7.3）points， and the difference in the ratio of Ⅲ-Ⅳ type， severe soft tissue defect， junior college or above， delayed ORIF， external treatment of traditional Chinese medicine and good compliance of functional training between the excellent and good group and control group had statistical significance（34.00%， 4.00%， 34.00%， 90.00%， 54.00%， 90.00% vs 63.16%， 24.56%， 12.28%， 57.89%， 35.09%， 66.67%）（P0.05）， and the delayed ORIF and good compliance of functional exercise became the protective factors and controllable factors. Conclusion We should scientifically arrange the functional training. 　　[Key words] Pilon fracture； Operative curative effect； High energy wound； Analysis of influence factors 　　Pilon骨折是指?骨远端干骺端波及胫距关节面的骨折，是一种常见的关节内骨折，常伴有严重的软组织损伤，占胫骨骨折的3%～10%，占下肢骨折的1%[1]。Pilon骨折预后整体较差，特别是高能量创伤致骨折者，术后并发症发生率高，因关节软骨损伤，常伴有关节僵硬等远期并发症[2]。近年来