Analysis Of Related Factors Of Nonunion In Treatment Of Tubular Bone Fracture Of Extremities By Minimally Invasive Technique

Objective: To explore the related factors of nonunion in the treatment of limb tubular fracture with minimally invasive technique.Methods:The data of nonunion of limbs caused by tubular bone fracture treated with minimally invasive technique in orthopedic trauma department of the first affiliated hospital of Wannan medical college from January 2012 to January 2019 were retrospectively collected,and 28 nonunion patients with complete medical records and imaging data were included,including 18 cases of lower limbs and 10 cases of upper limbs.According to the fracture location and internal fixation method of patients in the nonunion group,84 cases of patients with fracture healing after minimally invasive surgery were collected at the same time and under the same conditions according to 1:3 pairs,and their clinical data were reviewed and analyzed.Follow-up was conducted if necessary.Gender,age,smoking history,diabetes mellitus,injury energy,fracture type,fracture reduction,postoperative fracture end distance,soft tissue insertion,reasonable internal fixation,loading time,nutritional status at admission and other relevant factors of the patients with bone nonunion and fracture healing in the upper and lower limbs groups were analyzed and compared respectively.All data collected by the same staff,use the SPSS20.0 to deal with statistics data,categorical data expressed as a percentage,measurement data with mean + /-standard deviation,said first single factor analysis of each variable separately,in the single factor analysis variables have significant statistical significance(P < 0.05),and then into the binary classification Logistic regression analysis,P < 0.05 for the difference was statistically significant.Results:Single factor analysis results showed that gender,age,smoking history,diabetes history,injury energy and soft tissue insertion in the upper limb tubular bone nonunion group had no statistical significance compared with the upper limb fracture healing group(P > 0.05).The fracture types,reduction and internal fixation of the upper limb nonunion group were statistically significant(P < 0.05).In the multivariate analysis,the type of fracture and the irrationality of internal fixation were independent risk factors for the nonunion of tubular bone fractures in upper extremity caused by minimally invasive techniques.In the non-union group of lower limb tubular bone,the results of single factor analysis showed that gender,age,smoking history,diabetes history,injury energy and soft tissue insertion had no statistical significance compared with the lower limb fracture healing group(P > 0.05).The differences in fracture type,reduction,postoperative fracture distance,premature loading and internal fixation were statistically significant(P < 0.05).In the multivariate analysis,the unreasonable distance of the folded end and internal fixation after surgery were independent risk factors for the nonunion of lower limb tubular bone fractures caused by minimally invasive techniques.Conclusion:Fracture types and improper internal fixation are independent risk factors for nonunion of upper limb tubular bone fractures caused by minimally invasive techniques.The large distance between the broken ends and unreasonable internal fixation after surgery are independent risk factors for the nonunion of lower limb tubular bone fractures caused by minimally invasive techniques.The possibility of bone nonunion should be paid attention to after surgery in patients with fracture comminution type,poor reduction condition and premature loading.