股骨转子间骨折植入物内固定后髋内翻的影响因素

Influential factors for hip varus after internal fixation of intertrochanteric fracture

背景:股骨转子间骨折患者内固定治疗后易发生髋内翻,关于股骨转子间骨折的文献中,对手术方式的研究较多,而对其内固定后髋内翻的影响因素研究较少。目的:分析股骨转子间骨折患者内固定治疗后髋内翻的影响因素,探讨有效的预防措施。方法:选取接受内固定治疗的股骨转子间骨折患者80例。将患者的年龄、性别、体质量指数、骨折分型、骨密度、受伤至内固定时间、内固定方式、小转子复位情况、术后负重时间作为因变量进行赋值,内固定后是否发生髋内翻作为因变量,进行单因素分析,并进行Logistic回归分析。结果与结论:所有患者内固定后随访6个月以上。共12例患者内固定后发生髋内翻,发生率为15%,发生时间1-4个月。髋内翻角度94°-107°,平均99.1°。分析结果显示,骨折分型、骨密度、内固定后负重时间是股骨转子间骨折患者内固定治疗后髋内翻的影响因素(P<0.05);年龄、性别、体质量指数、受伤至手术时间、内固定方式、小转子复位情况不是股骨转子间骨折患者内固定治疗后髋内翻的影响因素(P>0.05)。将患者是否发生髋内翻作为因变量,将骨折分型、骨密度、内固定后负重时间作为自变量进行Logistic回归分析,结果显示骨折分型、骨密度、内固定后负重时间是引起股骨转子间骨折患者内固定治疗后髋内翻的独立危险因素。

BACKGROUND：Hip varus is likely to occur after internal fixation of intertrochanteric fracture. There are less studies on influential factors of hip varus after internal fixation. OBJECTIVE：To explore the influential factors of hip varus after internal fixation of intertrochanteric fracture. METHODS：Eighty patients with femoral fracture undergoing internal fixation treatment were selected. Single factor analysis and Logistic regression analysis were performed. Whether hip varus occurred or not served as dependent variable, and independent variables included age, sex, body mass index, fracture classification, bone mineral density, time from injury to internal fixation, internal fixation method, lesser trochanter restoration, postoperative weight-bearing time. RESULTS AND CONCLUSION：Al the patients were fol owed up for over 6 months postoperatively. Twelve patients had postoperative hip varus with an incidence rate of 15%. Hip varus occurred within 1-4 months after operation, with a mean coxa vara angle of 99.1°; （94°-107°）. Fracture classification, bone mineral density, postoperative weight-bearing time were influential factors for hip varus in patients with femoral fracture undergoing internal fixation （P〈0.05）. But age, sex, body mass index, time from injury to surgery, internal fixation method and lesser trochanter restoration were not influential factors （P〉0.05）. Logistic regression analysis showed that fracture classification, bone mineral density, postoperative weight-bearing time were independent risk factors for the occurrence of hip varus after internal fixation of intertrochanteric fracture.