股骨颈骨折不愈合高危因素的回顾性研究

A retrospective analysis of high risk factors for nonunion of femoral neck fractures

目的对股骨颈骨折术后不愈合的患者进行回顾性分析，探讨股骨颈骨折不愈合的高危因素。方法查阅2003年1月-2011年1月采用空心加压螺钉内固定治疗的股骨颈骨折患者1323例，其中资料完整且符合纳入标准患者965例。应用Logistic多元回归方法分别对患者年龄、性别、致伤机制（是否高能量损伤）、骨折类型（有无移位）、内科合并症[美国麻醉协会生理评分（American Society of Anesthesiologists Physical Score, ASAS）分级]等5种因素与骨折愈合的关系进行统计学分析，得出股骨颈骨折不愈合的高危因素。结果对影响股骨颈骨折愈合的因素进行定量测定依次为：内科合并症（ASAS分级）、致伤机制（是否高能量损伤）、骨折类型（有无移位）、性别、年龄。结论年龄〉50岁、女性、骨折移位、高能量损伤、ASASm级以上是股骨颈骨折不愈合的高危因素。

Objective To retrospectively study postoperative nonunion of femoral neck fractures so as to identify high risk factors for their nonunion. Methods A total of 965 patients with complete clinical data out of the 1 323 patients with femoral neck fractures treated by internal fixation with cannulated compression screws from January 2003 to January 2011 were included in the study. Logistic multiple regression method was used to analyze five factors including patients＇ age, gender, injury mechanism （whether high energy injury or not）, fracture type （with or without displacement） and medical comorbidities [ American Society of Anesthesiologists Physical Score （ASAS） grade ] and their correlation with fracture healing to investigate the high risk factors for the nonunion of femoral neck fractures. Results Quantitative assay of the factors affecting healing of femoral neck fractures was ranged as follows ： medical comorbidities （ASAS grade） , injury mechanism （whether high energy injury or not） , fracture type （with or without displacement）, gender and age. Conclusion Age 〉 50 years, females, displacement fracture, high energy injury, and ASAS grade above Ⅲ are high risk factors for nonunion of femoral neck fractures.