股骨颈骨折复位内固定术后股骨头坏死的发生率调查及相关因素分析

董巍

【摘要】 目的：調查股骨颈骨折复位内固定术后股骨头坏死的发生率，并分析相关危险因素。方法：对2012年10月-2014年10月本院收治的102例股骨颈骨折复位内固定术患者的临床资料进行回顾性研究，临床资料均来自病案室病历资料及随访结果，随访期截至2017年11月，所有患者均获得2年以上随访。采用单因素与Logistic多因素回归分析股骨颈骨折复位内固定术后发生股骨头坏死的相关因素。结果：102例内固定术后患者共发生股骨头坏死16例，坏死率15.69%。单因素分析发现，患者股骨颈骨折复位内固定术后股骨头坏死与年龄、受伤至手术时间、Garden分型、Garden指数、合并糖尿病、发生感染、体质指数（BMI）相关（P<0.05或0.01）。Logistic多因素回归分析结果显示，年龄≥65岁，受伤至手术时间≥5 d、Garden分型、Garden指数、合并糖尿病、发生感染、BMI≥25 kg/m2是股骨颈骨折复位内固定患者术后股骨头坏死的独立危险因素（P<0.05或0.01）。结论：目前股骨颈骨折复位内固定术后股骨头坏死发生率依然较高，需要针对相关危险因素加以重视。

【关键词】 股骨颈骨折； 内固定术； 股骨头坏死； 危险因素

Incidence and Related Factors of Femoral Head Necrosis after Reduction and Internal Fixation of Femoral Neck Fracture/DONG Wei.//Medical Innovation of China，2018，15（12）：106-109

【Abstract】 Objective：To investigate the incidence of femoral head necrosis after reduction and internal fixation of femoral neck fracture and analyze its related risk factors.Method：The clinical data of 102 patients with femoral neck fracture treated by reduction and internal fixation from October 2012 to October 2014 in our hospital were retrospectively studied and obtained from the medical records and follow-up results.All patients were followed up for more than 2 years until November 2017.Univariate and Logistic multivariate regression analysis were used to analyze the related factors of femoral head necrosis after reduction and internal fixation of femoral neck fracture.Result：16 cases of the femoral head osteonecrosis after internal fixation were found in 102 patients，and the necrosis rate was 15.69%.Univariate analysis showed that femoral head necrosis after femoral neck fracture reduction and internal fixation was related to age，time from injury to operation，Garden type，Garden index，diabetes，infection and body mass index（BMI）（P<0.05 or 0.01）.Logistic multivariate regression analysis showed that more than 65 years old，the time from injury to operation≥5 d，Garden type，Garden index，diabetes，infection，BMI≥25 kg/m2 were independent risk factors for femoral head necrosis after reduction and internal fixation in patients with femoral neck fracture（P<0.05 or 0.01）.Conclusion：The incidence of femoral head necrosis after internal fixation of femoral neck fracture is still high，and attention should be paid to related risk factors.

【Key words】 Femoral neck fracture； Internal fixation； Femoral head necrosis； Risk factors

First-authors address：Zhuanghe Central Hospital，Zhuanghe 116400，China

doi：10.3969/j.issn.1674-4985.2018.12.030

股骨颈骨折是临床常见的一种骨折类型，特别是在老年人及患有骨质疏松症等人群中发病率更高，近年来随着预期寿命延长以及快节奏的生活方式，股骨颈骨折发生率逐年增加[1-2]。临床治疗股骨颈骨折根据骨折类型和血供选择内固定术、全髋关节置换等治疗手段，目前内固定技术取得了较大进步，内固定术治疗股骨颈骨折愈合率已经得到临床广泛认可[3-4]。但是，仍有部分患者术后发生股骨头坏死，预防并降低股骨头坏死率是当前临床急需解决的重要问题[5]。因此，通过回顾性研究近年来本院复位内固定术治疗的102例股骨颈骨折患者的临床资料，观察术后股骨头坏死情况，并探究发生股骨头坏死的危险因素。……