|
|
- 2016
股骨颈骨折复位内固定术后股骨头坏死的相关危险因素分析
|
Abstract:
摘要：目的 探讨股骨颈骨折复位内固定术后股骨头坏死的相关危险因素。方法 回顾性分析2014年1月至2015年6月在我院行股骨颈骨折复位内固定手术治疗的145例患者的临床资料，对其中29例术后股骨头坏死的患者资料与同期其他患者的临床资料进行对比，应用Logistic回归分析比较两组患者年龄、性别、手术方式、骨折类型(Garden分型)、复位质量、伤后手术时间、术前牵引、负重时间、内固定是否取出等因素，分析可能导致术后股骨头坏死的危险因素。结果 单因素非条件Logistic回归分析显示，骨折类型(Garden分型)、复位质量、术前牵引与术后股骨头坏死有显著相关性(P<0.05)。多因素非条件Logistic回归分析显示，骨折类型(Garden分型)、复位质量、术前牵引显著相关(P<0.05)。 结论 骨折类型(Garden分型)、复位质量、术前牵引是股骨颈骨折内固定术后股骨头坏死的危险因素，而年龄、性别、手术方式、伤后手术时间和内固定是否取出等与术后股骨头坏死关系不密切。
ABSTRACT: Objective To investigate the correlation factors for femoral head necrosis after internal fixation in femoral neck fracture. Methods We made a retrospective analysis of the clinical data of 145 patients who underwent femoral neck fracture fixation surgery in our hospital between January 2014 and June 2015. We compared the clinical data of 29 patients with postoperative femoral head necrosis with those of the other patients treated at the same period. Logistic regression analysis was made to compare age, sex, surgery type, fracture type (Garden classification), quality of reduction, post-injury operation time, intraoperative traction, load time, internal fixation and other factors to explore the possible risk factors for postoperative femoral head necrosis. Results Univariate Logistic regression analysis showed that fracture type (Garden classification), quality of reduction, and preoperative traction were significantly correlated with postoperative femoral head necrosis (P<0.05). Multivariate Logistic regression analysis showed that fracture type (Garden classification), quality of reduction, preoperative traction had significant correlation (P<0.05). Conclusion Fracture type (Garden classification), quality of reduction, and preoperative traction are risk factors for femoral head necrosis after femoral neck fracture fixation. Age, sex, surgery type, surgery time after injury, and internal fixation are not closely related to postoperative femoral head necrosis
| [1] | AI ZS, GAO YS, SUN Y, et al. Logistic regression analysis of factors associated with avascular necrosis of the femoral head following femoral neck fractures in middle-aged and elderly patients[J]. J Orthop Sci, 2013, 18(2):271-276. |
| [2] | 危杰，周力，王满宜，等. 股骨颈骨折术后股骨头缺血性坏死的发生及转归[J]. 中华骨科杂志, 2005, 25(1):1-6. |
| [3] | 王强. 空心钉内固定治疗股骨颈骨折术后发生股骨头坏死的危险因素分析[J]. 临床和实验医学杂志, 2013, 12(22):1845-1847. |
| [4] | 王玉洲. 中空防旋加压螺钉治疗股骨颈骨折35例[J]. 郑州大学学报(医学版), 2003, 38(4):624. |
| [5] | 周锦春，郭敦明，王青，等. 股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死多中心多因素相关分析[J]. 中华骨科杂志, 2013, 33(5):549-554. |
| [6] | 刘粤，张长青，孟炜，等. 闭合复位空心钉治疗中老年股骨颈骨折后股骨头坏死的多元相关研究[J]. 中华创伤骨科杂志, 2006, 8(7):617-621. |
| [7] | NAUMOV I, WIEGAND N, PATCZAI B, et al. Differential scanning calorimetric examination of the human hyaline cartilage of the femoral head after femoral neck fracture[J]. J Therm Anal Calorim, 2012, 108(1):59-65. |
| [8] | TETSUNAGA T, AKAZAWA H. Intra-articular loose body caused by avascular necrosis of the femoral head in children[J]. J Pediatr Orthop B, 2014, 23(1):44-48. |
| [9] | LANDGRAEBER S, THEYSOHN JM, CLASSEN T, et al. Advanced core decompression, a new treatment option of avascular necrosis of the femoral head-a first follow-up[J]. J Tissue Eng Regen Med, 2013, 7(11):893-900 |
| [10] | 刘福尧，刘承伟，吴声忠，等. 不同置钉方式修复中青年移位型股骨颈骨折：复位质量及股骨头坏死率对比[J]. 中国组织工程研究, 2015, (31):4983-4988. |
| [11] | 马慧勇，曹江龙，李旭晨，等. 股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死的相关因素[J]. 中国老年学杂志, 2015, (4):988-989. |
| [12] | 王奉雷. 空心钉锁定板治疗股骨颈骨折术后股骨头坏死的危险因素分析[J].重庆医学, 2014, (8):909-912. |
| [13] | 艾自胜，张长青，刘粤，等. 股骨颈骨折内固定术后致股骨头坏死的影响因素分析[J]. 第二军医大学学报, 2008, 29(11):1350-1354. |
| [14] | 孙欣，曾荣，胡资兵，等. 空心螺钉内固定治疗股骨颈骨折术后股骨头坏死的影响因素分析[J]. 中华创伤骨科杂志, 2012, 14(6):477-479. |
| [15] | YERANOSIAN M, HORNEFF JG, BALDWIN K, et al. Factors affecting the outcome of fractures of the femoral neck in children and adolescents: a systematic review[J]. Bone Joint J, 2013, 95-B(1):135-142. |
| [16] | ZHAO DW, HU YC. Chinese experts？？ consensus on the diagnosis and treatment of osteonecrosis of the femoral head in ？？adults？？[J]. Orthop Surg, 2012, 4(3):125-130. |
