外伤性股骨头缺血性坏死相关危险因素研究  

Analysis of the risk related factors in traumatic avascular necrosis of femoral head

作　　者：彭加友[1] 史德刚[1] 栗国梁[1] 吴家昌[2] 

机构地区：[1]广州中医药大学附属佛山中医院放射科,528000 [2]贵阳医学院附属医院放射科,550004

出　　处：《贵州医药》2007年第2期124-126,共3页Guizhou Medical Journal

基　　金：广东省佛山市卫生局立项课题(2003040)

摘　　要：目的分析股骨颈骨折后发生股骨头缺血性坏死的相关危险因素。方法回顾性研究1384例股骨颈骨折患者的临床及X线资料。结果骨折Garden分型:Ⅰ型18例(1.3%),Ⅱ型494例(35.7%),Ⅲ型720例(52.0%),Ⅳ型152例(11.0%)。发生股骨头坏死114例(8.2%),绝大多数在骨折后3年内发现,股骨头晚期塌陷55例(4.0%)。骨折GardenⅠ-Ⅳ型的股骨头缺血坏死率分别为0%、5.9%、9.6%、10.5%,晚期塌陷率分别为0%、1.6%、5.1%、6.6%。4组年龄(<20岁、20～40岁、40～60岁、>60岁)的坏死率和晚期塌陷率分别为48.4%、15.6%、10.5%、3.8%和14.5%、8.2%、6.1%、2.0%,股骨颈骨折后股骨头坏死发生率随年龄增加而降低。结论股骨颈骨折Garden分型和年龄是发生股骨头缺血性坏死和晚期塌陷的主要危险因素,GardenⅢ、Ⅳ型和青少年发病率高。Objective To analyses the risk related factors in traumatic avascular necrosis of the femoral head （ANFH）. MethodsThe clinical and X-ray data of 1384 patients with femoral neck fractures were reviewed retrospectively. ResultsAmong the patients with femoral neck fractures, Garden stages was used with type Ⅰ 18 cases, type Ⅱ 494 cases, type Ⅲ 720 cases and type Ⅳ 152 cases AN- FH happened in 114 patients who were mostly found within 3 years after fracture, meanwhile, the segmental collapse of femoral head developed in 55 patients. From type Ⅰ to Ⅳ of Garden stage, the incidence of ANFH was 0% ,5. 9%, 9. 6% 10. 5% respectively, and late collapse of femoral head was 0 %, 1.6 %, 5. 1%, 6. 6 % respectively. In four groups divided by patient＇s age （〈20,20-40, 40-60, 60 years old individually）, the incidence of ANFH was 48. 4%, 15.6 %, 10. 5 %, 3. 8% and late collapse of the femoral head was 14. 5 %, 8. 2%, 6. 1%, 2. 0% respectively. With the increasing of age, the incidence of ANFH reduced. Conclusion Garden stage of femoral neck fractures and patients＇ age are major risk factors contributed to the accidence of ANFH and late collapse of femoral head, which is very high in type Ⅲ to Ⅳ of Garden stages and adolescent.

关 键 词：股骨颈骨折 股骨头坏死 危险因素 

分 类 号：R683.42[医药卫生—骨科学] R681.8[医药卫生—外科学]