摘要
目的:通过Logistic回归分析,从统计学角度进一步认识儿童肱骨髁上骨折保守治疗后发生肘内翻的危险因素,从而指导临床治疗。方法:回顾性分析2008年3月至2014年12月行手法复位石膏固定的肱骨髁上骨折患儿,收集其年龄、性别、体重指数(BMI)、伤后至复位时间、移位方向、旋转移位、骨骺损伤、固定位置等资料。对以上资料进行单因素分析,初步筛选出可能的危险因素,再对单因素分析有意义的因素进行多因素Logistic回归分析,从而最终明确导致肘内翻的危险因素。结果:单因素分析显示伤后至复位时间、移位方向、旋转移位、骨骺损伤对肘内翻的发生有显著影响,多因素Logistic回归分析显示儿童肱骨髁上骨折保守治疗后发生肘内翻的独立危险因素分别是伤后至复位时间(伤后至复位时间>8 h比伤后至复位时间<8 h更容易导致肘内翻)[P=0.017,OR=3.303(1.243-8.774)],尺偏型移位[P=0.001,OR=11.951(2.895-49.335)],旋转移位[P=0.003,OR=4.190(1.643-10.685)],骨骺损伤[P=0.000,OR=7.092(2.557-19.671)]。结论 :伤后至复位时间、尺偏型移位、旋转移位以及骨骺损伤是导致儿童肱骨髁上骨折保守治疗后发生肘内翻的主要危险因素,应根据不同危险因素采取相应的处理方法。
Objective：To further investigate the risk factors of cubitus varus in humeral condylar fracture after conserva- tive treatment in children through Logistic regression analysis, so as to guide the clinical treatment. Methods：Children with humeral condylar fracture who were treated by manipulative reduction and plaster fixation in our hospital from March 2008 to December 2014 were studied. The clinical data including age,gender,BMI,time from injury to reduction,direction of displacement, rotation displacement, fixed position, and epiphyseal injury were collected. First, preliminary screen the risk factors through univariate analysis of the above data,then determine the risk factors of cubitus varus through multivariate Logistic regression analysis of the significant factors from univariate analysis. Results： Univariate analysis showed that time from injury to reduction, direction of displacement, rotation displacement and epiphyseal injury were significantly correlated with the cubitus varus. Multivariate Logistic regression analysis showed that time from injury to reduction which was longer than 8 h [P=0.017, OR =3.303 （ 1.243 -8.774） ], ulnar displacement [P=0.001, OR =11.951 （2.895 -49.335） ], rotation displacement [P=0.003, OR=4.190（1.643-10.685） ]and epiphyseal injury [P=-0.000,OR=7.092（2.557-19.671 ） ] were independent risk factors of cubitus varus. Conclusion ：Time from injury to reduction, ulnar displacement,rotation displacement and epiphyseal injury are independent risk factors of cubitus varus. So it need corresponding treatment according to different risk factors.
出处
《中国骨伤》
CAS
2017年第5期431-435,共5页
China Journal of Orthopaedics and Traumatology
关键词
肱骨髁上骨折
肘内翻
危险因素
儿童
Humeral condylar fracture
Cubitus varus
Risk factors
Child
