骨密度与胫骨平台骨折ORIF术后患者临床结局的关系

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Abstract Objective To investigate the relationship between bone mineral density and clinical outcomes of open reduction and internal fixation(ORIF) in patients with tibial plateau fractures.Methods Open reduction and internal fixation(ORIF) in 100 patients with tibial plateau fractures in our hospital from Jan 2012 to Dec 2016 were selected as study subjects.According to the score of 1 years postoperative knee function(HSS)，patients were divided into HSS≥70 scores group(n＝72) and HSS＜70 score group(n＝28).Data of treatment and follow-up were collected for all enrolled patients，including gender，age，body mass index(BMI)，smoking history，drinking history，history of diabetes，hypertension，hyperlipidemia，initial platform collapse depth，postoperative complications，postoperative reduction etc.The differences in clinical characteristics between the two groups were compared.Univariate and multivariate unconditional Logistic regression analysis were used to analyze the risk factors of clinical outcomes in patients with ORIF after tibial plateau surgery.Results There were significant differences between the two groups in age，history of diabetes，Schatzker classification，initial platform collapse depth，postoperative complications，postoperative reduction and bone mineral density T(P＜0.05)，there were no significant differences in gender，BMI，history of smoking，history of alcohol abuse，history of hypertension，number of cases with hyperlipidemia，and cause of injury(P＞0.05).Single factor Logistic regression analysis showed that age，history of diabetes，Schatzker type，initial platform collapse depth，postoperative complications，postoperative reduction，bone mineral density T value were the risk factor affecting the clinical outcome of patients with tibial plateau after ORIF(P＜0.05).The above variables for multivariate Logistic regression analysis showed that age≥60 years old，had a history of diabetes，Schatzker type Ⅳ~Ⅵ，bone mineral density T value≤－1.0 were not conducive to the clinical outcome of tibial plateau ORIF patients(P＜0.05).Conclusion Bone mineral density is closely related to clinical outcomes in patients with tibial plateau fractures after ORIF surgery，bone mineral density T value≤－1.0 is not conducive to the clinical outcome of postoperative patients with tibial plateau ORIF.

Key words： bone mineral density fracture of tibial plateau open reduction and internal fixation clinical outcome

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