股骨颈骨折术后股骨头缺血坏死的多因素分析

A Multiple Correlation Factors Analysis of Femoral Head Necrosis in Old Patients Neck Fractures after Cannulated Screws Fixation

目的探讨影响空心螺钉治疗老年人股骨颈骨折术后股骨头缺血性坏死的因素。方法对2000年1月至2006年1月间采用空心螺钉治疗的115例老年人股骨颈骨折患者进行回顾性总结,将患者性别、年龄、外伤至手术时间、骨折Garden分型、Garden指数以及基础病与股骨头缺血性坏死间的关系进行统计学分析。结果影响空心螺钉治疗老年人股骨颈骨折术后股骨头缺血性坏死的相关因素和顺序依次为骨折Garden分型、患者年龄、受伤至手术时间、Garden指数、基础病,性别对股骨头缺血性坏死的影响不大。结论骨折移位是影响空心螺钉治疗老年人股骨颈骨折预后最为关键的因素。可控因素中,受伤至手术时间及骨折复位质量Garden指数明显影响预后。老年人年龄及其基础病增加股骨头缺血性坏死的发生概率。

Objective To investigate factors related to avascular necrosis of femoral head through a retrospective study of old patients with femoral neck fractures treated with cannulated screws. Methods One hundred and fifteen old patients with femoral neck fracture were admitted from January 2000 to January 2006 and treated with eannulated screws. We analyzed statistically the multiple factors：age ,gender ,Garden classification ,time interval from injury to surgery,quality of reduction （Garden Index）,and base disease by SPSS 10.0 statistic system. Results Factors that might have an impact on avascular necrosis of femoral head were ranked in the following likelihood sequence：Garden classification ,age ,time interval from injury to surgery ,Garden Index and base disease. Gender was found to have little impact on the prognosis of femoral neck fracture. Conclusion Fracture displacement is the most critical factor that influences the prognosis. Time interval from injury to surgery and Garden Index ,as important controllable factors ,influence the prognosis of femoral neck fracture. High age and base disease will lead to increased incidences of avascular necrosis.