Iatrogenic Factors Analysis Of Knee Extensor Device Adhesion Of The Femoral Lower-middle Section Fracture Postoperation

Objective:This study aimed to discussion the iatrogenic factors of knee adhesion of the femoral lower-middle section fracture postoperation, provide a reference for the clinicians to further improve the treatment methods and reduce the knee adhesion complications.Methods:Collection the information of patients operated on the femoral lower-middle section fracture fixation in Fuzhou General Hospital from January,2007 to January,2010,and the information of patients diagnosed as knee extensor device adhesion,90 cases in total. Statistical and analysis the iatrogenic factors such as different surgical approaches, internal fixation methods, fracture restoration, postoperative gesso external fixation time, herbal fumigation, postoperative function exercise, different timing of operation, etc. The data was dealt withΧ2 test nd multivariate Logistic regression analysis(the paramenters with P<0.05). All data processing were completed with SPSS13.0.Results:This are 90 cases in total,78 patients were from our hospital,12 cases were from outside hospital, all cases have been followed up, average follow-up time 18.7 months. Single factor analysis, the results:surgical approaches, internal fixation methods, fracture restoration, postoperative gesso external fixation time, herbal fumigation, postoperative function exercise were statistically significance(P<0.05), timing of operation was not statistically significance (P> 0.05). Logistic regression analysis results shown:surgical approaches, internal fixation methods, postoperative gesso external fixation time, functional exercise are the independent factors of knee extensor device adhesion (P< 0.05).Conclusion:(1) The surgical approaches, internal fixation methods, fracture restoration situation postoperative gesso external fixation, herbal fumigation,functional exercise are the iatrogenic factors, among them,the surgical approaches, internal fixation methods, postoperative gesso external fixation time, functional exercise are the independent factors. (2) The treatment of the femoral lower-middle section fracture, open reduction internal fixation,adopt posterolateral surgical approach can greatly reduce knee extensor device adhesion. (3) Intramedullary nail fixed is a ideal method. (4) According to local wound healing postoperative,using CPM functional exercise cooperate with herbal fumigation, can reduce the incidence of extensor device adhesion.