张孝平

【摘要】 目的：分析影響成人肱骨远端骨折手术疗效的非感染因素，为提高疗效提供参考依据。方法：收集2012年3月-2018年12月就诊于监利市中医院行手术治疗的129例新鲜单侧闭合性肱骨远端骨折患者的临床资料，分析年龄、性别、身体质量指数、致伤原因、骨折侧别、骨折分型、神经血管损伤、手术固定方式、骨折复位质量等非感染因素对疗效的影响。结果：129例患者经评定，48例为优，45例为良，25例为可，11例为差，优良率为72.09%。单因素分析显示，骨折分型、神经血管损伤、骨折固定方式、骨折复位质量是肱骨远端骨折手术疗效的影响因素（P<0.05）;而年龄、性别、身体质量指数、致伤原因、骨折侧别尚不能作为肱骨远端骨折手术疗效的影响因素（P>0.05）。多元线性回归分析显示，神经血管损伤、手术固定方式、骨折复位质量是肱骨远端骨折手术疗效的独立影响因素（P<0.05），而骨折分型尚不能作为独立影响因素（P>0.05）。结论：成人肱骨远端骨折手术疗效的非感染因素中，合并神经血管损伤是危险因素，骨折解剖复位、锁定钢板固定是保护因素，临床中需给予重视。

【关键词】 肱骨髁间骨折 肱骨髁上骨折 骨折复位

Analysis of Non Infectious Factors Affecting Surgical Treatment of Distal Humeral Fractures in Adults/ZHANG Xiaoping. //Medical Innovation of China， 2021， 18（14）： 0-030

[Abstract] Objective： To analyze the non infectious factors affecting the operative effect of adult distal humeral fractures， and to provide reference for improving the curative effect. Method： Clinical data of 129 patients with fresh unilateral closed distal humerus fracture who received surgical treatment in Jianli Hospital of Traditional Chinese Medicine from March 2012 to December 2018 were collected. The effects of non-infectious factors such as age， gender， body mass index， injury cause， fracture side type， fracture type， neurovascular injury， surgical fixation method and fracture reduction quality on the curative effect were analyzed. Result： Of the 129 patients， 48 were rated as excellent， 45 as good， 25 as fair， and 11 as poor， with an excellent and good rate of 72.09%. Univariate analysis showed that fracture type， neurovascular injury， fixation method and quality of fracture reduction were the influential factors for the surgical outcome of distal humerus fracture （P<0.05）; however， age， gender， body mass index， injury cause and fracture side were not considered as the influencing factors for the surgical outcome of distal humerus fracture （P>0.05）. Multiple linear regression analysis showed that neurovascular injury， surgical fixation method and fracture reduction quality were independent influencing factors for the surgical outcome of distal humerus fracture （P<0.05）， and fracture type could not be used as an independent factor （P>0.05）. Conclusion： Among the non-infectious factors for the surgical effect of adult distal humerus fracture， combined neurovascular injury is the risk factor， and anatomical reduction of fracture and locking plate fixation are the protective factors， which should be paid more attention in clinic.

[Key words] Humeral intercondylar fracture Supracondylar fracture of humerus Reduction of fracture

First-authors address： Jianli Hospital of Traditional Chinese Medicine， Jianli 433300， China

doi：10.3969/j.issn.1674-4985.2021.14.007

成人肱骨远端骨折在临床并不多见，但年发病率随着交通的飞速发展和建筑事业持续膨胀已达（6～34）/10万，在全身、肱骨骨折的发病比例分别为2%～6%、17%～23%[1-3]，由于治疗难度大、手术疗效不理想成为骨科领域近年的研究热点。目前，感染作为影响骨折手术疗效的主要因素虽得到公认，但仍有近30%的非感染性肱骨远端骨折患者得不到预期手术疗效[4-6]，故而有必要进一步探讨非感染性疗效影响因素。本研究筛选影响成人肱骨遠端骨折手术疗效的非感染因素，为提高疗效提供参考依据。……