股骨颈骨折空心加压螺钉内固定术后股骨头缺血性坏死危险因素分析  

Analysis of risk factors for avascular necrosis of femoral head in patients with femoral neck fracture after cannulated compression screw internal fixation

作　　者：邓邦瑾[1] 张卫红[1] 文政[1] 牛闯来 

机构地区：[1]深圳平乐骨伤科医院骨七科,广东深圳518010

出　　处：《新乡医学院学报》2017年第6期526-528,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨股骨颈骨折(FNF)空心加压螺钉内固定术后股骨头缺血性坏死(ANFH)的危险因素,为临床防治ANFH提供参考。方法回顾性分析2008年1月至2011年12月于深圳平乐骨伤科医院行空心加压螺钉内固定手术治疗的150例FNF患者的临床资料,术后随访3~6 a,统计ANFH发生情况,并采用单因素分析和多因素logistic回归分析对ANFH发生的危险因素进行分析。结果 150例患者中,术后发生ANFH 21例,未发生ANFH 129例,ANFH发生率为14.0%(21/150)。单因素分析显示,受伤至手术时间、骨折Garden分型、Garden指数及术后开始负重时间与ANFH的发生有关(P<0.05),而患者性别、年龄、复位方式及内固定是否取出与ANFH的发生无关(P>0.05)。Logistic回归分析显示,骨折Garden分型、Garden指数、受伤至手术时间及术后开始负重时间是ANFH发生的危险因素(P<0.05)。结论 FNF空心加压螺钉内固定术后ANFH的发生与多种因素有关,应针对ANFH发生的危险因素采取预防和干预措施,从而降低ANFH发生率,改善患者预后。Objective To investigate the risk factors for avascular necrosis of femoral head （ANFH） in patients with femoral neck fracture（FNF） after cannulated compression screw internal fixation,and to provide reference for clinical prevention and treatment of ANFH.Methods The clinical data of 150 patients with FNF who underwent cannulated compression screw internal fixation in Shenzhen Pingle Orthopedic Hospital from January 2008 to December 2011 were analyzed retrospectively.All patients were followed up for 3-6 years,and the incidence of ANFH was observed.The risk factors for ANFH were analyzed by univariate analysis and multivariate logistic regression analysis.Results Among the 150 cases,ANFH occurred in 21 cases,and ANFH did not occur in 129 cases after operation,the incidence of ANFH was 14.0% （21/150）.Univariate analysis showed that the time from injury to operation,Garden type of fracture,Garden index and the time of starting weightbearing after operation were related to the occurrence of ANFH （P 〈0.05）;but the gender,age,reduction way and whether to remove the internal fixation were not associated with the occurrence of ANFH （P 〉 0.05）.Logistic regression analysis showed that the Garden type of fracture,Garden index,the time from injury to operation and the time of starting weight-bearing after operation were the risk factors for ANFH（P 〈 0.05）.Conclusions The occurrence of ANFH is related to many factors in patients with FNF after cannulated compression screw internal fixation.The prevention and intervention measures should be taken according to the risk factors for ANFH,so as to reduce the incidence of ANFH and improve the prognosis of patients.

关 键 词：股骨颈骨折 内固定术 空心加压螺钉 股骨头坏死 危险因素 

分 类 号：R683.42[医药卫生—骨科学]