股骨颈骨折后股骨头坏死影响因素研究进展

Research Progress on Influencing Factors of Femoral Head Necrosis after Femoral Neck Fracture

股骨颈骨折是股骨头坏死(ONFH)的主要原因之一,老年股骨颈骨折患者可以选择人工股骨头置换术或全髋关节置换术治疗。但对于年轻股骨颈骨折患者,骨折常由暴力引起,且考虑到他们未来生活质量与关节功能,关节置换术并不是首选的治疗方法,髓芯减压术、截骨术、带血管骨移植术等保髋治疗成为更适合的治疗选择。近年来股骨颈骨折的发病年龄呈现年轻化趋势。了解股骨颈骨折后ONFH的影响因素,有助于指导管理决策,早期预测和评估有助于早期治疗。本文将近年研究股骨颈骨折导致ONFH的机制与影响因素的相关文献做一综述,以提高临床医生对股骨颈骨折患者发生ONFH的认识、预防ONFH的发生。

Femoral neck fracture is one of the major causes of osteonecrosis of the femoral head(ONFH).Elderly patients with femoral neck fracture can choose artificial femoral head replacement or total hip replacement for treatment.However,for young patients with femoral neck fracture,the fracture is often caused by violence,and considering their future quality of life and joint function,joint replacement is not the preferred choice of treatment.Coxa decompression,osteotomy,and vascularized bone transplantation are more appropriate treatment options for hip preservation.In recent years,the age of onset of femoral neck fracture shows a trend towards younger age.Understanding the influencing factors of ONFH after femoral neck fracture is helpful to guide management decision,and early prediction and evaluation is helpful for early treatment.This article reviews the relevant literature on the mechanism and influencing factors of ONFH caused by femoral neck fracture,so as to improve clinicians'understanding of ONFH in patients with femoral neck fracture and prevent the occurrence of ONFH.