股骨颈骨折内固定术后股骨头坏死危险因素研究

To Investigate the Causes of Femoral Head Necrosis after Internal Fixation of Femoral Neck Fractures and Provide Reliable Reference for Clinical Diagnosis and Treatment of the Disease

目的:探讨造成股骨颈骨折内固定术后股骨头坏死的因素,以为疾病临床诊治提供更可靠的参照.方法:采集2013年3月-2015年2月期间择期行内固定手术治疗的120例股骨颈骨折患者资料,逐一分析患者年龄、性别、骨折类型( Garden分型)、手术方式、手术时间、术前牵引治疗及内固定是否取出等因素对术后股骨头坏死产生的影响.结果:术后进行为期12 -36个月的随访观察,22例(18. 3% )患者内固定术后发生了股骨头坏死,发生时间为(17. 4 ± 1. 7)个月.单因素分析表明,高骨折分型、术前牵引、受伤至手术时间>1周、内固定物取出是造成患者术后发生股骨头坏死的危险因素(P<0. 05);Logistic回归直线分析表明,骨折分型、术前牵引、受伤至手术时间、内固定物取出是诱发骨头坏死的独立危险因素(P<0. 05).结论:股骨颈骨折患者行内固定治疗后,股骨头坏死的风险较高,影响因素相对较多,临床应加强预防,以不断优化疾病治疗效果.

Objective:To investigate the causes of femoral head necrosis after internal fixation of femoral neck fractures and provide reliable reference for clinical diagnosis and treatment of the disease.Meth ods:120 cases of femoral neck fracture treated with internal fixation were collected from 2013.3 to 2015.2.One by one,the effects of age,sex,fracture type(Garden classification),operation mode,operation time,preoperative traction treatment,and internal fixation on postoperative femoral head necrosis were analyzed.R esults:In 22 patients(18.3%),femoral head necrosis occurred after internal fixation,which occurred in(17.4±1.7)months.The single factor analysis showed that high fracture classification,preoperative traction,injury to surgery time>1 week,and internal fixation removal were the risk factors for femoral head necrosis after surgery(P<UNK>0.05);Logitic regression linear analysis showed that fracture typing,preoperative traction,injury to surgery time,and removal of internal fixation were independent risk factors for bone necrosis(P<UNK>0.05).Conclusion:the risk of femoral head necrosis is higher and there are more influencing factors after internal fixation in patients with femoral neck fracture.