影响股骨颈骨折术后股骨头缺血性坏死的多因素分析  

Analysis of factors related to prognosis of femoral neck fracture

作　　者：勘武生[1] 黄方敏[1] 郑琼[1] 谢鸣[1] 李鹏[1] 黄珩[1] 彭永海[1] 陈明[1] 王俊文[1] 周必光[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院武汉骨科医院骨科,武汉430033

出　　处：《中华创伤骨科杂志》2006年第6期520-523,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的回顾性分析股骨颈骨折行中空螺纹钉内固定术后,影响股骨头缺血性坏死的相关因素。方法1994年8月～2003年10月采用中空螺纹钉内固定治疗股骨颈骨折230例。应用秩和检验方法分别对患者年龄、性别、骨折类型、复位方式、骨折复位质量、受伤至手术时间等6种因素对于股骨头缺血性坏死发生的影响进行统计学分析,并采用Logistic多因素回归得出相关顺序。结果影响股骨颈骨折术后股骨头缺血性坏死的相关因素和顺序依次为骨折类型、骨折复位质量、复位方式、受伤至于术时间、患者年龄；性别的不同对股骨头缺血性坏死的影响不大(P＞0．05)。结论骨折移位是影响预后最为关键的因素。我们所能控制的因素中,骨折复位质量、复位方式及受伤至手术时间明显影响预后。患者高龄并未造成股骨头缺血性坏死率上升。Objective To find out factors related to avascular necrosis （AVN） of femoral head through a retrospective study of patients with femoral neck fractures treated with cannulated screws. Methods Two hundred and thirty cases of femoral neck fracture who had been treated with cannulated screws in our department from August 1994 to October 2003 were analyzed statistically. Six factors of patient, age, gender, fracture type （Garden classification）, reduction method （close or open）, the quality of reduction （Garden Index） and time interval from injury to surgery were analyzed statistically with rank sum test and logistic multiple regression. Results Factors that might have an impact on avascular necrosis of femoral head were ranked in the following likelihood sequence： fracture type, quality of reduction, reduction method, time interval from injury to surgery and age. Gender was found to have little impact on the prognosis of femoral neck fracture （ P 〉 0. 05 ）. Conclusions Fracture displacement is the most critical factor that influences the prognosis. Anatomical reduction （close or open） must be achieved to reduce the risk of AVN. Timing of surgery shows its importance. High age will not lead to an increased incidence of AVN.

关 键 词：股骨颈骨折 股骨头 缺血性坏死 预后 

分 类 号：R687.3[医药卫生—骨科学]