207例股骨颈骨折的危险因素分析

Risk factors analysis of 207 patients with femoral neck fracture

目的回顾性分析影响股骨颈骨折移位的危险因素。方法对2015年9月~2018年10月在我院诊治的符合标准股骨颈骨折患者的临床资料进行回顾性分析,按骨折端是否移位分为无移位型(GardenⅠ、Ⅱ型)及移位型(GardenⅢ、Ⅳ型)两组。先对两组患者性别、年龄、骨密度(BMD)、体质指数(BMI)、股骨颈干角及所受能量因素进行单因素分析并进行χ^2检验,筛选出差异有统计学意义的指标。然后将相关因素进行赋值并行Logistic回归分析确定其危险因素。结果本研究共纳入207例股骨颈骨折患者,其中无移位型骨折59例(28.5%),移位型骨折148例(71.5%)。两组患者的年龄、颈干角与所受能量差异有统计学意义(P<0.05)。Logistic回归分析发现,年龄(P=0.000,OR=14.610,95%CI:4.513~47.301)、所受能量(P=0.014,OR=13.371,95%CI:1.698~105.321)、颈干角(P=0.000,OR=0.144,95%CI:0.068~0.304)为股骨近端骨折的的独立危险因素。结论股骨颈骨折患者中移位型骨折的发生率较高,高龄、高能量及小颈干角是股骨颈骨折发生移位的危险因素,即在其余变量大致相同的情况下,年龄越大、所受能量越高、颈干角越小的患者容易发生股骨颈骨折移位。

Objective To retrospectively analyzed the risk factors affecting displacement of femoral neck fracture.Methods The clinical data of patients with standard femoral neck fracture diagnosed and treated in our hospital from September 2015 to October 2018 were retrospectively analyzed.The patients were divided into non-displaced group(GardenⅠandⅡ)and displaced group(GardenⅢandⅣ)according to whether the fracture end was displaced or not.Gender,age,bone mineral density(BMD),body mass index(BMI),femoral neck stem angle and energy received in the two groups were analyzed by univariate analysis andχ2 test to screen out the indexes with statistical significance.Then the related factors were assigned and the risk factors were determined by Logistic regression analysis.Results A total of 207 patients with femoral neck fractures were enrolled in this study,including 59 patients with undisplaced fractures(28.5%)and 148 patients with displaced fractures(71.5%).There were statistically significant differences between the two groups in age,cervical angle and energy received(P<0.05).Logistic regression analysis showed that age(P=0.000,OR=14.610,95%CI:4.513-47.301),energy received(P=0.014,OR=13.371,95%CI:1.698-105.321)and cervical trunk angle(P=0.000,OR=0.144,95%CI:0.068-0.304)were independent risk factors for proximal femoral fractures.Conclusion Patients with femoral neck fracture have a higher incidence of displaced fracture.Elderly age,high energy and small cervical trunk angle are risk factors for displacement of femoral neck fracture.In other words,patients with older age,higher energy and smaller cervical trunk angle are more likely to have displacement of femoral neck fracture when the other variables are roughly the same.