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患者因素和手术对胫骨近端骨折恢复的影响——一项回顾性分析。

Effect of patient factors and procedure on proximal tibia fracture recovery - A retrospective analysis.

作者信息

Ahmad Tashfeen, Muhammad Zehra Abdul, Zehra Fatima

机构信息

Tashfeen Ahmad, FCPS, PhD. Assistant Professor, Departments of Surgery and Biological & Biomedical Sciences, The Aga Khan University, Karachi, Pakistan.

Zehra Abdul Muhammad, MBBS, MSc. Senior Instructor, Department of Surgery, The Aga Khan University, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2024 Nov;40(10):2281-2286. doi: 10.12669/pjms.40.10.9154.

Abstract

OBJECTIVE

Tibia plateau fractures account for 1-2% of all fractures and might adversely affect the knee joint. The current research aimed to evaluate the effect of surgical procedures, age, and gender on proximal tibia fracture functional outcomes.

METHODS

The present data for the retrospective analysis was obtained from an observational longitudinal cohort trauma registry study, initiated at a tertiary care hospital in June 2015. A total of 51 isolated tibia plateau fracture patients were routinely treated with open reduction internal fixation or external fixator and assessed for functional outcomes till twelve months by the Rasmussen scoring scale. Patients were divided into five age groups. The functional outcome association to gender, age groups, and surgical procedures was assessed by the Fisher Exact test and logistic regression analysis.

RESULTS

The mean age of the total 51 patients was 40±11 years. Patients operated with Open Reduction and Internal Fixation (74.5%) or with an external fixator (25.5%). Road traffic accidents were the common mechanism of injury. There were non-significantly different functional outcomes observed among age groups or between surgical procedures at all follow-ups but significantly different between genders at three-month follow-ups. Males recovered better than females (p=0.02).

CONCLUSION

Tibia Plateau fracture patients respond almost equally to both external fixation and Open Reduction Internal Fixation procedures. Age does not influence the outcome. However, males had better functional outcomes at three months post-surgery indicating that gender could affect the outcomes. Further exploration might assist in planning gender-based proximal tibia fracture treatment strategies for optimum outcomes.

摘要

目的

胫骨平台骨折占所有骨折的1%-2%,可能会对膝关节产生不利影响。当前研究旨在评估手术方式、年龄和性别对胫骨近端骨折功能预后的影响。

方法

本回顾性分析的数据来自于一项观察性纵向队列创伤登记研究,该研究于2015年6月在一家三级护理医院启动。共有51例单纯胫骨平台骨折患者常规接受切开复位内固定或外固定架治疗,并通过拉斯穆森评分量表评估至12个月时的功能预后。患者被分为五个年龄组。通过Fisher精确检验和逻辑回归分析评估功能预后与性别、年龄组和手术方式之间的关联。

结果

51例患者的平均年龄为40±11岁。采用切开复位内固定手术的患者占74.5%,采用外固定架手术的患者占25.5%。道路交通事故是常见的受伤机制。在所有随访中,各年龄组之间或手术方式之间观察到的功能预后无显著差异,但在3个月随访时性别之间存在显著差异。男性恢复情况优于女性(p=0.02)。

结论

胫骨平台骨折患者对外固定和切开复位内固定手术的反应几乎相同。年龄不影响预后。然而,男性在术后3个月的功能预后更好,这表明性别可能会影响预后。进一步探索可能有助于制定基于性别的胫骨近端骨折治疗策略以实现最佳预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeea/11568702/e3d28790499e/PJMS-40-2281-g001.jpg

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