股骨转子间骨折内固定失败的相关因素及全髋关节置换术治疗效果分析  

The influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthroplasty treatment

作　　者：张喜海[1] 叶俊武[1] 卓乃强[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《临床和实验医学杂志》2015年第22期1886-1889,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨股骨转子间骨折内固定失败的相关因素及全髋关节置换术的治疗效果。方法回顾性分析2010~2012年收治得股骨转子间骨折及股骨胫骨骨折患者119例,收集其基本信息及临床资料,将单因素分析结果具有统计学意义的指标纳入到Logistic多因素回归模型当中,探讨可能影响患者股骨转子间骨折内固定失败的相关因素。总结内固定失败患者采用全髋关节置换术的治疗效果。结果单因素相关分析显示,骨骼类型、骨骼质量、骨折原因、内固定位置、复位程度和后内侧骨皮质距离均是影响患者内固定失败的危险因素,将有统计学意义的因素纳入Logistic回归模型,结果显示,骨折类型、骨骼质量、骨质复位程度是影响患者股骨转子间骨折内固定失败最主要的危险因素。其中,骨折类型是最大的影响因素（OR=5.331）。全髋关节置换术结果显示,患者术后与术前相比,Harris评分、疼痛评分、行走评分、功能评分、活动评分均明显的增高,差异均具有统计学意义（P〈0.05）。结论骨折类型、骨骼质量、骨质复位程度是影响患者股骨转子间骨折内固定失败的危险因素。其中,骨折类型是最大的影响因素。患者内固定失败后采用全髋关节置换术进行再治疗能够获得比较满意的疗效。Objective To investigate the influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthroplasty treatment. Methods A retrospective analysis were performed in our hospital from 2010 to 2012. Total 119 cases of femoral intertrochanteric fractures and tibial fractures were admitted. The information in all patients were collected included basic information and clinical data. A statistically significant indicators were choosen into multiple Logistic regression model,adjusting for confounding variables,and exploring the factors that may affect patients with hip fracture fixation failure. Results Univariate analysis showed that the medial bone type,bone mass,fractures reason,a fixed location,extent and reset after cortical distance were the main risk factors affecting the patient fixation failure. A significant factors were included in the Logistic regression model. The results showed that the type of fracture,bone mass,bone fixation failure reset extent the impact of hip fracture patients were the main risk factors. Among them,the fracture type is the biggest factor（ OR = 5. 331）. After fixation failure,patients were treated with total hip arthroplasty. The results showed that Harris score,pain score,walking score,score,activity scores were significantly higher compared with patients before surgery（ P〈 0. 05）. Conclusion The type of fracture,bone mass,bone reset extent were the main risk factors for hip fracture patient fixation. Among them,the fracture type is the biggest factor（ OR = 5. 331）. After fixation failure in the patients with total hip arthroplasty for re- treatment can obtain satisfactory results.

关 键 词：股骨转子间骨折 内固定 全髋关节置换术 

分 类 号：R687.3[医药卫生—骨科学]