股骨颈骨折复位内固定术后股骨头坏死的相关危险因素分析

The correlation factors for femoral head necrosis after internal fixation in femoral neck fracture

目的探讨股骨颈骨折复位内固定术后股骨头坏死的相关危险因素。方法回顾性分析2014年1月至2015年6月在我院行股骨颈骨折复位内固定手术治疗的145例患者的临床资料,对其中29例术后股骨头坏死的患者资料与同期其他患者的临床资料进行对比,应用Logistic回归分析比较两组患者年龄、性别、手术方式、骨折类型(Garden分型)、复位质量、伤后手术时间、术前牵引、负重时间、内固定是否取出等因素,分析可能导致术后股骨头坏死的危险因素。结果单因素非条件Logistic回归分析显示,骨折类型(Garden分型)、复位质量、术前牵引与术后股骨头坏死有显著相关性(P<0.05)。多因素非条件Logistic回归分析显示,骨折类型(Garden分型)、复位质量、术前牵引显著相关(P<0.05)。结论骨折类型(Garden分型)、复位质量、术前牵引是股骨颈骨折内固定术后股骨头坏死的危险因素,而年龄、性别、手术方式、伤后手术时间和内固定是否取出等与术后股骨头坏死关系不密切。

Objective To investigate the correlation factors for femoral head necrosis after internal fixation in femoral neck fracture. Methods We made a retrospective analysis of the clinical data of 145 patients who underwent femoral neck fracture fixation surgery in our hospital between January 2014 and June 2015. We compared the clinical data of 29 patients with postoperative femoral head necrosis with those of the other patients treated at the same period. Logistic regression analysis was made to compare age, sex, surgery type, fracture type （Garden classification）, quality of reduction, post-injury operation time, intraoperative traction, load time, internal fixation and other factors to explore the possible risk factors for postoperative femoral head necrosis. Results Univariate Logistic regression analysis showed that fracture type （Garden classification）, quality of reduction, and preoperative traction were significantly correlated with postoperative femoral head necrosis （P-0.05）. Multivariate Logistic regression analysis showed that fracture type （Garden classification）, quality of reduction, preoperative traction had significant correlation （P〈0.05）. Oonclusion Fracture type （Garden classification）, quality of reduction, and preoperative traction are risk factors for femoral head necrosis after femoral neck fracture fixation. Age, sex, surgery type, surgery time after injury, and internal fixation are not closely related to postoperative femoral head necrosis.