踝关节骨折术后功能恢复的多因素分析

Analysis of Multiple Factors Affecting Functional Recovery after Ankle Fracture

摘要: 目的：探讨踝关节骨折术后功能恢复的相关影响因素。方法：回顾性分析2019~2020年在青海大学附属医院收治的82例踝关节骨折术后临床资料。依据AOFAS评分标准将研究对象分为优，良，差3组，并统计术后并发症的发生情况。据术后1a随访结果82例患者术后踝关节功能优50例，良20例，差12例，优良率为85.36% (70/82)；术后切口延迟愈合10例，切口感染7例，下胫腓拉力螺钉断裂3例，出现并发症患者均经过临床系统治疗后恢复。结果：单因素分析显示，3组患者年龄、是否跟骨牵引、是否放置引流管、伤后几日行手术治疗、手术时间、是否存在感染等进行比较差异有统计学意义(P < 0.05)。logistic回归分析结果显示，年龄 > 50岁(OR = 5.43)、未做跟骨牵引(OR = 14.853)、存在感染(OR = 5.512)是影响踝关骨折术后功能恢复的独立危险因素(P < 0.05)。结论：年龄较大、相关骨折类型未行跟骨牵引、术后存在感染均是影响踝关节术后功能恢复的不利因素。

Abstract: Objective: To explore the related factors of functional recovery after ankle joint fracture. Methods: The clinical data of 82 cases of ankle fracture treated in Qinghai University Affiliated Hospital from 2019 to 2020 were retrospectively analyzed. According to AOFAS scoring criteria, the subjects were divided into three groups: excellent, good, average and poor. According to 1a follow-up results of 82 patients, postoperative ankle joint function was excellent in 50 cases, good in 20 cases, fair or poor in 12 cases, the excellent and good rate was 85.36% (70/82). There were 10 cases of delayed inci-sion healing, 7 cases of incision infection, and 3 cases of tibiofibular lag screw fracture. All the pa-tients with complications recovered after clinical systematic treatment. Results: Univariate analysis showed that there were statistically significant differences in age, calcaneal traction, drainage tube placement, surgical treatment days after injury, surgical time and infection among 3 groups (P < 0.05). Logistic regression analysis showed that age > 50 years (OR = 5.43), no calcaneus traction (OR = 14.853), and infection (OR = 5.512) were independent risk factors affecting functional recovery after ankle closure fracture (P < 0.05). Conclusion: Older age, lack of calcaneal traction and postop-erative infection are the negative factors affecting functional recovery of ankle joint.