目的:本回顾性研究旨在探讨胫腓骨联合螺钉(SS)断裂的相关因素。
方法:包括69例不稳定的AO-Weber44-B型踝关节骨折患者,这些患者接受了三个皮质SS(3.5mm)的固定。患者随访至少一年(平均,18.3±7.6个月)。在最后的后续行动中,在年龄方面比较了断裂(I组)和完整(II组)SS患者,性别,高度,体重,身体质量指数,骨折类型,SS长度,location,和取向。采用多因素logistic回归分析确定与SS断裂相关的独立危险因素。敏感性,特异性,截止值,分析ROC曲线下面积。
结果:逐步反向逻辑回归分析显示,年龄是SS破损的唯一独立预测因素(OR=0.938,95%CI=0.904-0.973,R2=0.270)。ROC曲线分析表明,年龄小于36岁的患者SS断裂风险增加7倍[赔率比(95%CI),7.042(2.251-22.031)]。
结论:36岁以下的年龄是SS断裂的唯一重要危险因素。对于年龄小于36岁的患者,可以告知联合骨螺钉断裂的发生率更高。
OBJECTIVE: This retrospective study aimed to investigate the factors associated with the breakage of tibio-fibular syndesmotic screws (SS).
METHODS: 69 patients with unstable AO-Weber Type 44-B ankle fractures who underwent three cortex SS (3.5 mm ø) fixation were included. Patients were followed for at least one year (mean, 18.3 ± 7.6 months). At the final follow-up, patients with broken (Group I) and intact (Group II) SS were compared regarding age, gender, height, weight, body mass index, fracture type, SS length, location, and orientation. Multivariate logistic regression was used to identify the independent risk factors associated with SS breakage. The sensitivity, specificity, cut-off value, and area under the ROC curve were analyzed.
RESULTS: A stepwise backward logistic regression analysis revealed that age was the only independent predictor for SS breakage (OR = 0.938, 95% CI = 0.904-0.973, R2 = 0.270). ROC curve analysis demonstrated that patients younger than 36 years were associated with seven times increased risk of SS breakage [Odds ratio (95% CI), 7.042 (2.251-22.031)].
CONCLUSIONS: Age under 36 years was the only significant risk factor for SS breakage. The higher incidence of breakage of the syndesmotic screw can be informed to patients younger than 36.