下地时间对股骨颈骨折术后股骨头坏死的影响

Relationship Between On Weight Bearing Time and Femoral Head Necrosis after Operation of Femoral Neck Fracture

目的:探讨股骨颈骨折后股骨头缺血性坏死的发生与手术后下地不负重活动时间的关系,为手术后正确指导患者功能锻炼提供理论依据。方法:对139例股骨颈骨折行内固定治疗的病例进行5～10年的随访。根据患者术后下地时间分为3个月内下地组(41例)、3～6个月下地组(50例)以及6个月后下地组(48例),分析比较各组间股骨头坏死发生率,并进行统计学分析。结果:共发生股骨头坏死43例,发生率31%。其中3个月内下地组17例,3～6个月下地组13例,6个月后下地组13例。根据统计学分析,手术后3个月内下地组股骨头坏死发生率明显高于其他2组(P<0.05),而3～6个月和6个月后下地组之间股骨头坏死的发生率无统计学差异。结论:股骨颈骨折术后股骨头坏死的发生随手术后下地时间的不同而不同,其中术后3～6个月之间下地不负重活动,更有利于患者功能的恢复。

Objective： To investigate the relationship between on weight beating time and femoral head necrosis after operation of femoralneck fracture, and to provide theoretic basis for the proper exercise after operation.Methods ： The 139 cases of femoral neck fracture were followed-up for 5~10 years after fixation operation. They were randomly divided into three groups according to their on weight beating time after operation, on weight bearing time before 3 months （3-month-group）, on weight beating time between 3 and 6 months （3~6-monthgroup）,on weight bearing time after 6 months （6-month-group）. The rate of femoral head necrosis was analyzed and compared in eachgroups. SPSS 11.0 Stat. software was used to analyze the results.Results： There were 43 femoral head necrosis occurred in all cases. Thetotal necrosis rate was 31%.17 cases in 3-month-group, 13 cases in 3~6-month-group,13 cases in 6-month-group.The necrosis rate of 3-month-group was higher than other groups （P〈0.05）. The difference in the necrosis rate between 3~6-month-group and 6-month-group was not significant （P 〉0.05）. Conclusion： The rate of femoral head necrosis after the femoral neck fracture differs with the time of on weight beaing. Among them, unloaded activity between 3 and 6 months is the best way to restitution their function.