The Clinical Analysis On Risk Factors Of Refracture After Callus Distraction

Objective:To determine the incidence of refracture after callus distraction and explore the risk factors associated with refracture so as to find out the preventive measures.Methods:There are 177 patients(198 limbs)undergoing distraction osteogenesis by the inlaied external fixator from April 2005 to October 2009.The lenthening limbs of these patients are clinical healing up.Collected them and make a restrospective study in them.The risk factors of refracture are assessed through establishing a database using Excel,making variable assignment and statistical analysis using SPSS.17.0.For Single-factor analysis,measurement data use mean±standard deviation(x±s),count data use%χ2 tests,for multi-factor analysis,non-conditional multi-factor Logistics regression is adopted,with P<0.05 making statistically significant differ-ence.Results:According to the criteria for refracture,177patients (1981imbs) are analyzed,with 19 cases falling under refracture,the refracture rate being 9.60%.The results of single factor analysis areas follows.The refracture rate correlated with the position of lenthening limbs.The refracture rate of patients who undergoing legs lenthening is significantly higher than that of the patients who undergoing arms lengthening.While in the patients who undergoing legs lengthening, the refracture rate of tibia lengthening is significantly higher than that of femur lengthening.The refracture rate correlated with the age of the patients.The refracture rate of patients who older than 20 is significantly higher than that of the patients who younger than 20.The refracture rate correlated with the lengthening distance. The longer the lengthening distance,the higher the refracture rate.While the distance is no more than 3cm, the refracture rate is 5.84%,while the distance is between 3 and 5cm, the refracture rateis 6.31%.while the distance is above 5cm, the refracture rate is 20.41%.The refracture rate of patients who had operation in the lengthening limb before is significantly higher than that of the patients who had no operation in the lengthening limb.The refracture rate correlated with the aetiology.While the patients who have limb discrepancy due to congenital has the highest refracture rate(19.35 %).The patients who have bone loss due to trama or nonunion or osteomyelitis has the second refracture rate(6.52%),while the refracture rate of the others patients is the lowest(4.35%).Patients'gender,whether leg lengthening by simultaneous lengthening of femur and tibia, have no significantly statistical relation with refracture rates.The multi-factor non-conditional logistic regression analysis shows that the aetiology and the lengthening distance are independent risk factors of refracture, and that the relative degree of risk are 2.914,2.644 respectively.Conclusions:The incidence of refracture after callus distraction by the inlaied external fixator is 9.60%.The position of the lengthening limbs,the lengthening distance and the factors of patients himself(age and aetiology),whether had operation in the lengthening limb before are risk factors of refracture,among these factors,the aetiologyand the lengthening distance are independent risk factors of refracture。...