股骨颈骨折闭合复位空心钉内固定术后股骨头坏死相关因素分析

摘要

Objective:To explore related factors of femoral head necrosis after operation of femoral neck fracture.Methods:Retrospectively summarized 86 cases treated by closed reduction with percutaneous cannulated screw ifxation.Data such as age,gender,fracture type,reduction time,reduction quality and full weight bearing time of 86 patients with complete follow-up were statistically analyzed.Results:After 12~24 months follow-up,15 cases had femoral head necrosis,the necrosis rate was 17.44%and the time of femoral head necrosis was 8~24 months after operation.The independent risk factors affecting avascular necrosis of the femoral head were age(χ2=4.59,P=0.039),fracture type(χ2=6.391,P=0.011)and quality of reduction(χ2=4.143,P=0.041). Through Logistic analysis of various factors,the results were age OR = 8.977,P = 0.01,quality of reduction OR=0.026,P=0.02.Conclusion:The patients' age,fracture type and reduction quality all could affect the rate of postoperative necrosis of the femoral neck fracture with cannulated screw internal ifxation,among which the patients' age and quality of reduction were the main factors affecting the femoral neck fracture healing.%目的：探讨影响股骨颈骨折术后导致股骨头坏死的各相关因素。方法：对行闭合复位经皮空心钉固定术且随访资料完整的86例患者的年龄、性别、骨折类型、复位时间、复位质量、完全负重时间等资料进行统计学分析。结果：随访12～24个月，15例出现股骨头坏死，坏死率为17.44％，发生坏死的时间为术后8～24个月。影响股骨头坏死的独立危险因素为年龄（χ2=4.59，P=0.039）、骨折类型（χ2=6.391，P=0.011）、复位质量（χ2=4.143，P=0.041），通过对各因素进行Logistic分析，结果显示年龄OR=8.977，P=0.01，复位质量OR=0.026，P=0.02。结论：患者年龄、骨折类型、复位质量均可影响股骨颈骨折空心钉内固定术后坏死率，而年龄及复位质量影响最大。