踝关节骨折后发生骨质疏松的相关危险因素分析

目的探讨踝关节骨折后发生骨质疏松(OP)的相关危险因素。方法收集新疆医科大学第一附属医院2009年1月—2013年12月期间因踝关节骨折行手术治疗患者207例的围手术期临床资料,以骨折后6个月内是否发生骨质疏松为标准分组,对围术期相关影响因素进行单因素和多因素Logistic回归分析。结果多因素Logistic回归分析结果显示:有4个指标对骨折后6个月内发生骨质疏松具有显著性差异,其中糖尿病病史、术后发生骨筋膜室综合征(OCS)为骨折6个月内发生骨质疏松的独立危险因素,其OR值分别为2.84(1.75~5.41)、2.28(1.11~6.58)。手术方式的选择和抗骨质疏松治疗为独立保护因素,其OR值分别为0.32(0.28~0.67)、0.29(0.17~0.45)。结论对于踝关节骨折患者选择内固定术,合并糖尿病合理控制血糖,术后预防并发症和选择合理抗骨质疏松方法治疗、早期功能锻炼可有效预防后期骨质疏松症的发生。

Analysis of the relevant risk factors of osteoporosis after ankle fracture

Objective To discuss the relevant risk factors on the incidence of osteoporosis ( OP) after ankle fracture.Methods The clinical data of 207 ankle fracture patients who received surgery in our hospital from Jan .2009 to Dec.2013 were enrolled and divided into two groups according to the incidence of OP at six months after fracture.One-way and multiple Logistic regression analysis were used to analyze the perioperative relevant factors . Results Multiple Logistic regression analysis showed that four factors had significant difference in affecting the in -cidence of OP at six months after fracture;among them,diabetes and the occurrence of osteofascial compartment syn-drome(OCS)were independent risk factors , and their OR values were 2.841.75-5.41] and 2.281.11-6.58], respectively .Surgical operation and anti-osteoporosis therapy were independent protection factors ,and their OR val-ues were 0.320.28-0.67] and 0.290.17-0.45],respectively.Conclusion Suitable selection of internal fixa-tion, glycemic control for diabetic patients ,prevention of postoperative complications ,postoperative functional exer-cise and effective anti-osteoporosis therapy can prevent the incidence of OP after fracture .