肱骨干骨折延迟愈合及不愈合的相关因素分析

目的：探讨导致肱骨干骨折延迟愈合及不愈合的相关因素。方法：回顾性分析93例肱骨干骨折患者的病例资料，其中31例肱骨干骨折延迟愈合及不愈合患者纳入观察组，62例肱骨干骨折骨性愈合患者纳入对照组。比较2组患者的骨折粉碎、骨折端软组织损伤、骨折复位、固定不稳、感染及不合理功能活动情况。结果：观察组中23例为严重粉碎性骨折患者，对照组中26例为严重粉碎性骨折患者；观察组中严重粉碎性骨折患者的比例大于对照组（χ^2=8.627，p =0.003）；其相对危险度是对照组的3.981倍。观察组中固定不稳25例，对照组中固定不稳13例；观察组中固定不稳患者的比例大于对照组（χ^2=30.459，p =0.000）；其相对危险度是对照组的15.705倍。观察组中不合理功能活动患者26例，对照组中12例；观察组中不合理功能活动患者的比例大于对照组（χ^2=35.598，p =0.000）；其相对危险度是对照组的21.667倍。观察组在骨折端软组织损伤情况、骨折复位和感染三方面与对照组相比，组间差异均无统计学意义（χ^2=1.902，p =0.168；χ^2=0.939，p =0.332；χ^2=0.661，p =0.416）。结论：肱骨干骨折后发生延迟愈合及不愈合主要与不合理的功能活动、固定不稳及严重粉碎性骨折有关联，但骨折延迟愈合及不愈合的发生绝不是单一因素作用的结果，而是混杂了多种因素的交叉作用结果。对于各因素间有无交互效应及其相关性，我们将继续收集资料做进一步分析研究。

Study on relevant factors of humeral shaft fracture delayed union and disunion

Objective：To explore the relevant factors of humeral shaft fracture delayed union and disunion. Methods：The medical re-cords of 93 patients with humeral shaft fracture were analyzed retrospectively. Thirty-one patients with humeral shaft fracture delayed union and disunion were recruited into the observation group,while 62 patients with humeral shaft fracture bone union were recruited into the con-trol group. Then the two groups were compared with each other in degree of fracture comminution,soft tissue injury around broken ends of fractured bone,fracture reduction,fixation instability,infection and unreasonable functional activities. Results：Twenty-three patients were diagnosed as severe comminuted fracture in observation group,while 26 patients were diagnosed as severe comminuted fracture in control group. The proportion of patients with severe comminuted fracture was larger in observation group compared to control group（χ2 = 8. 627, p = 0. 003）,and the relative risk of severe comminuted fracture of observation group was 3. 981 times of that of control group. There were 25 patients with fixation instability in observation group,while 13 patients in control group. The proportion of patients with fixation instability was larger in observation group compared to control group（χ^2 = 30. 459,p = 0. 000）,and the relative risk of observation group was 15. 705 times of that of control group. There were 26 patients with unreasonable functional activities in observation group,while 12 patients in control group. The proportion of patients with unreasonable functional activities was larger in observation group compared to control group（χ^2 =35. 598,p = 0. 000）,and the relative risk of observation group was 21. 667 times of that of control group. There was no statistical difference in degree of soft tissue injury around broken ends of fractured bone,fracture reduction and infection between the 2 groups（χ^2 = 1. 902,p =0. 168;χ^2 = 0. 939,p = 0. 332;χ^2 = 0. 661,p = 0. 416）. Conclusion：The humera