Zhao Hongfang, Tian Siyu, Kong Lingde, Bai Jiangbo, Lu Jian, Zhang Bing, Tian Dehu
Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, People's Republic of China.
Ther Clin Risk Manag. 2018 Jun 19;14:1127-1131. doi: 10.2147/TCRM.S169310. eCollection 2018.
The aim of this study was to investigate the union time of acute middle-third scaphoid fractures following treatments and to analyze the effect of different factors on late union.
We retrospectively reviewed patients with acute middle-third scaphoid fracture at our institution between January 2013 and December 2017. Patient demographics, fracture characteristics, and treatment strategy, such as age, gender, body mass index, habit of smoking, sides of injury, dominant hand, ulnar variance, multiple fractures, and treatment methods, were investigated. Univariate and multivariate analyses were used to identify possible predictive factors.
A total of 132 patients with scaphoid fracture were included in our study. Operation was performed in 67 patients (50.8%), and conservative treatment was performed in the other 65 patients (49.2%). The union time was 7.2±0.5 weeks. In the multivariate logistic regression analysis, late diagnosis (odds ratio, 1.247; 95% CI, 1.022-1.521) and conservative treatment method (odds ratio, 1.615; 95% CI, 1.031-2.528) were identified as 2 independent predictors of late union in scaphoid fractures patients. Other parameters were not demonstrated to be predictive factors.
Late diagnosis and conservative treatment were two factors associated with late union. Long time of follow-up is necessary for patient with these factors.
本研究旨在调查急性舟状骨中1/3骨折治疗后的愈合时间，并分析不同因素对延迟愈合的影响。
我们回顾性分析了2013年1月至2017年12月在我院就诊的急性舟状骨中1/3骨折患者。调查了患者的人口统计学特征、骨折特点及治疗策略，如年龄、性别、体重指数、吸烟习惯、受伤侧别、优势手、尺骨变异、多发骨折及治疗方法。采用单因素和多因素分析来确定可能的预测因素。
本研究共纳入132例舟状骨骨折患者。67例（50.8%）患者接受了手术治疗，另外65例（49.2%）患者接受了保守治疗。愈合时间为7.2±0.5周。多因素逻辑回归分析显示，延迟诊断（比值比，1.247；95%可信区间，1.022-1.521）和保守治疗方法（比值比，1.615；95%可信区间，1.031-2.528）是舟状骨骨折患者延迟愈合的2个独立预测因素。其他参数未被证明是预测因素。
延迟诊断和保守治疗是与延迟愈合相关的两个因素。对于存在这些因素的患者，需要进行长时间随访。
