股骨颈骨折复位内固定术后股骨头坏死的发生率调查及相关因素分析

Incidence and Related Factors of Femoral Head Necrosis after Reduction and Internal Fixation of Femoral Neck Fracture

目的:调查股骨颈骨折复位内固定术后股骨头坏死的发生率,并分析相关危险因素。方法:对2012年10月-2014年10月本院收治的102例股骨颈骨折复位内固定术患者的临床资料进行回顾性研究,临床资料均来自病案室病历资料及随访结果,随访期截至2017年11月,所有患者均获得2年以上随访。采用单因素与Logistic多因素回归分析股骨颈骨折复位内固定术后发生股骨头坏死的相关因素。结果:102例内固定术后患者共发生股骨头坏死16例,坏死率15.69%。单因素分析发现,患者股骨颈骨折复位内固定术后股骨头坏死与年龄、受伤至手术时间、Garden分型、Garden指数、合并糖尿病、发生感染、体质指数(BMI)相关(P<0.05或0.01)。Logistic多因素回归分析结果显示,年龄≥65岁,受伤至手术时间≥5 d、Garden分型、Garden指数、合并糖尿病、发生感染、BMI≥25 kg/m2是股骨颈骨折复位内固定患者术后股骨头坏死的独立危险因素(P<0.05或0.01)。结论:目前股骨颈骨折复位内固定术后股骨头坏死发生率依然较高,需要针对相关危险因素加以重视。

Objective：To investigate the incidence of femoral head necrosis after reduction and internal fixation of femoral neck fracture and analyze its related risk factors.Method：The clinical data of 102 patients with femoral neck fracture treated by reduction and internal fixation from October 2012 to October 2014 in our hospital were retrospectively studied and obtained from the medical records and follow-up results.All patients were followed up for more than 2 years until November 2017.Univariate and Logistic multivariate regression analysis were used to analyze the related factors of femoral head necrosis after reduction and internal fixation of femoral neck fracture.Result：16 cases of the femoral head osteonecrosis after internal fixation were found in 102 patients,and the necrosis rate was 15.69%.Univariate analysis showed that femoral head necrosis after femoral neck fracture reduction and internal fixation was related to age,time from injury to operation,Garden type,Garden index,diabetes,infection and body mass index（BMI）（P〈0.05 or 0.01）.Logistic multivariate regression analysis showed that more than 65 years old,the time from injury to operation≥5 d,Garden type,Garden index,diabetes,infection,BMI≥25 kg/m^2 were independent risk factors for femoral head necrosis after reduction and internal fixation in patients with femoral neck fracture（P〈0.05 or 0.01）.Conclusion：The incidence of femoral head necrosis after internal fixation of femoral neck fracture is still high,and attention should be paid to related risk factors.