股骨颈骨折患者并发股骨头坏死的预后相关影响因素

Prognostic factors of femoral head necrosis in patients with femoral neck fracture

创伤引发的股骨颈骨折是临床上常见的骨科疾病之一,而其后续发生的以股骨头缺血坏死为代表的并发症是导致患者出现下肢运动功能障碍的主要原因之一。目前对于创伤后股骨颈骨折具体的损伤及修复机制仍不甚明了,因此研究股骨颈骨折后患者身体的各项指标及临床上针对的治疗措施对预后产生的影响,可为预测股骨颈骨折患者未来的预后打好基础,并为采取相应的干预手段提供思路。目前主要认为创伤后股骨颈血供不足和相关炎性重建反应是创伤性股骨头坏死的主要作用机制,而作用于相关机制的因素则被认为是其可能的危险因素。本文整理了近年来对于股骨颈骨折后续发生坏死相关影响因素的报道。学界主要认为受伤原因、Garden分型等骨折分型方式、内固定方式及复位质量等因素被认为是导致预后不良的可能危险因素。

Femoral neck fracture caused by trauma is one of the common orthopedic diseases in clinical practice,and its subsequent complications represented by femoral head ischemic necrosis are now one of the main causes of lower limb motor dysfunction in patients.For posttraumatic femoral neck fracture specific injury and repair mechanisms are still unclear,so the understanding of the femoral neck fracture patients after the body of the indicators and clinically for the treatment of the influence on prognosis could be used to predict future outcomes for patients with femoral neck fractures groundwork,and to take appropriate interventions.At present,it is considered that inadequate blood supply to the femoral neck and associated inflammatory reconstructive response are the main mechanisms of traumatic femoral head necrosis,while factors acting on the related mechanisms are considered as possible risk factors.This paper reviews the recent reports on the factors related to necrosis after femoral neck fracture.Factors such as the cause of injury,Garden type and other fracture types,internal fixation and reduction quality are considered as possible risk factors for poor prognosis.