股骨颈骨折复位内固定术后股骨颈短缩危险因素分析  

Analysis of risk factors for femoral neck shortening after reduction and internal fixation of femoral neck fracture

作　　者：陈德[1] 王海洋[1] 郭思远[1] 王龙岗 CHEN De;WANG Hai-yang;GUO Si-yuan;WANG Long-gang(Department of Orthopedics,Wanbei Coal Power Group General Hospital,The Third Affiliated Hospital of Bengbu Medical College,Suzhou 234000,China)

机构地区：[1]皖北煤电集团总医院(蚌埠医学院第三附属医院)骨二科,安徽宿州234000

出　　处：《创伤与急危重病医学》2020年第6期434-437,共4页Trauma and Critical Care Medicine

基　　金：安徽省自然科学基金项目(1408085MH207)。

摘　　要：目的探讨股骨颈骨折患者复位内固定术后股骨颈短缩的发生情况及其危险因素。方法选取自2015年1月至2018年6月收治的接受空心钉内固定治疗的116例股骨颈骨折患者为研究对象。根据术后患者在随访期间的X线影像测量股骨颈短缩情况。收集患者的年龄、性别、体质量指数、受伤至手术时间、骨折Garden分型、复位质量及Singh指数等临床资料,采用单因素及多因素logistic回归分析影响股骨颈短缩的相关危险因素。结果本组116例股骨颈骨折患者中,复位内固定术后股骨颈短缩≥5 mm的发生率为43.1%(50/116)。单因素分析结果显示,患者年龄、体质量指数、受伤至手术时间、骨密度T值、Garden分型、Pauwels分型、Garden对线指数、Singh指数、负重时间、术后Harris评分与股骨颈骨折复位内固定术后股骨颈短缩的发生有关。多因素Logistic回归分析结果显示,年龄>60岁、骨密度T值≤-2.5、Garden分型(Ⅲ~Ⅳ型)、Pauwels分型(Ⅲ型)、Garden对线指数(Ⅲ~Ⅳ型)、负重时间≤2个月和术后Harris评分是股骨颈骨折复位内固定术后股骨颈短缩发生的独立危险因素。结论年龄>60岁、骨密度T值≤-2.5、Garden分型(Ⅲ~Ⅳ型)、Pauwels分型(Ⅲ型)、Garden对线指数(Ⅲ~Ⅳ型)、负重时间≤2个月和术后Harris评分是股骨颈骨折复位内固定术后股骨颈短缩发生的独立危险因素,早期识别并对危险因素进行干预,可降低股骨颈骨折患者复位内固定术后股骨颈短缩的发生风险。Objective To investigate the incidence and risk factors of femoral neck shortening after reduction and internal fixation in patients with femoral neck fracture.Methods A retrospective study was performed on 116 cases of patients with femoral neck fracture who were admitted and performed hollow nail fixation from January 2015 to June 2018.Femoral neck shortening was measured according to the X-ray performance of the postoperative patients during follow-up.The clinical data such as age,sex,body mass index,time from injury to operation,Garden type of fracture,reduction quality and Singh index was collected.Univariate and multivariate logistic regression analysis were used to analyze the related risk factors of femoral neck shortening.Results In 116 patients with femoral neck fractures,the incidence of femoral neck shortening≥5 mm after reduction and internal fixation was 43.10%(50/116).Univariate analysis showed that the age,body mass index,time from injury to operation,bone mineral density T value,Garden classification,Pauwels classification,Garden alignment index,Singh index,weight-bearing time,Harris score after operation were closely related to the occurrence of femoral neck shortening.The results of multivariate logistic regression analysis showed that age>60 years old,bone mineral density T value≤-2.5,fracture Garden type(typeⅢ-Ⅳ),Pauwels type(typeⅢ),Garden alignment index(typeⅢ-Ⅳ),weight-bearing time≤2 months and postoperative Harris score reduction were important risk factors for femoral neck shortening after reduction and internal fixation of femoral neck fracture.Conclusion Age>60 years,bone mineral density T value≤-2.5,Garden fracture type(typeⅢ-Ⅳ),Pauwels type(typeⅢ),Garden alignment index(typeⅢ-Ⅳ),weight-bearing time≤2 months,postoperative Harris score reduction is an important risk factor for femoral neck shortening after fracture.Early identification and intervention of risk factors can reduce the risk of postoperative complications of femoral neck fractures.

关 键 词：股骨颈骨折 股骨颈短缩 危险因素 

分 类 号：R687.3[医药卫生—骨科学]