影响股骨颈骨折内固定后髋关节功能的多因素分析  

Multifactor analysis of hip joint function following internal fixation for femoral neck fracture

作　　者：黄方敏[1] 勘武生[1] 蔡宗强[1] 徐剑[1] 

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

出　　处：《中国组织工程研究与临床康复》2008年第26期5135-5138,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：中空加压螺钉内固定治疗股骨颈骨折后髋关节功能的恢复程度有所不同,哪些因素对髋关节功能的恢复有重要作用？目的：分析股骨颈骨折行中空螺纹钉内固定后影响髋关节功能的相关因素。设计、时间及地点：回顾性分析,1994-08/2003-10华中科技大学同济医学院附属普爱医院骨科采用中空螺纹钉内固定治疗股骨颈骨折230例患者资料。对象：采用中空螺纹钉内固定治疗股骨颈骨折230例。男132例,平均年龄49.7岁（18-79岁）;女98例,平均年龄52.3岁（23-83岁）。方法：应用卡方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种因素对髋关节功能的影响进行统计学分析。同时,采用Spearman等级相关分析上述影响因素与内固定后髋关节功能的关系。主要观察指标：①不同影响因素与髋关节功能Harris评分的卡方检验结果。②不同影响因素与髋关节功能Harris评分的Spearman等级相关分析结果。结果：①不同骨折类型组间、不同受伤至手术时间组间、不同Garden指数组间髋关节功能Harris评分差异有显著性意义（χ^2=29.372,29.883,21.357;P=0.001,0.000,0.011）。②骨折类型、受伤至手术时间、Garden指数与髋关节功能Harris评分显著相关（相关系数依次为-0.200,-0.115,-0.133;P值依次为0.045,0.001,0.024）。结论：骨折移位是影响内固定后髋关节功能的重要因素。在人为控制的因素中,骨折复位质量、受伤至手术时间明显影响预后。BACKGROUND： Cannulated screw internal fixation improves hip function recovery after femoral neck fractures at different extents. Which factor can influence the hip function recovery？ OBJECTIVE： To explore the factors related to the function of hip joint in patients with femoral neck fractures treated with cannulated screws. DESIGN, TIME AND SETTING： Retrospective analysis was performed at Department of Orthopedics, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology from August 1994 to October 2003. PARTICIPANTS： 230 cases of femoral neck fractures treated with cannulated screws were selected, including 132 males with an average age of 49.7 years （range, 18-79 years） and 98 females with an average age of 52.3 years （range, 23-83 years）. METHODS： Six factors of patient including age, gender, fracture type （Garden classification）, reduction method （close or open）, quality of reduction （Garden Index） and time interval from injury to surgery were analyzed statistically with Chi-square. In addition, the relationship of the six factors with hip function after internal fixation was analyzed using Spearman grading. MAIN OUTCOME MEASURES： Chi-square results of different influential factors and Harris scoring of hip joint function; Spearman grading of different influential factors and Harris scoring of hip joint function. RESULTS： There were significant differences in Harris scores of fracture type, Garden Index, and time interval from injury to surgery between different groups （Х^2=29.372, 29.883, 21.357; P =0.001, 0.000, 0.011）. Factors such as fracture type, time interval from injury to surgery, and Garden Index had significant impact on the Harris scores of function of hip joint （r =-0.200, -0.115, -0.133; P =0.045, 0.001,0.024）. CONCLUSION： Fracture displacement is an important factor that influences the function of hip joint. Quality of anatomical reduction and time interval from injury significantly influence the prognosis.

关 键 词：股骨颈骨折 内固定 髋关节功能 

分 类 号：R318[医药卫生—生物医学工程]