股骨颈骨折患者行空心钉固定术后发生股骨头坏死的相关因素  

Related Factors of Femoral Head Necrosis Fixation in Patients with Neck Fracture after Hollow Screw Fixation

作　　者：聂润华[1] 许纯锐 吴小宝[1] 牛晓健[1] 温伟 NIE Runhua;XU Chunrui;WU Xiaobao;NIU Xiaojian;WEN Wei(No.907 Hospital of Joint Service Support Force of the Chinese People’s Liberation Army,Nanping 354200,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九〇七医院,福建南平354200 [2]武夷山市立医院 [3]宁都翠微医院

出　　处：《中外医学研究》2022年第9期41-44,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析股骨颈骨折患者行空心钉固定术后发生股骨头坏死的相关因素。方法:回顾性分析中国人民解放军联勤保障部队第九〇七医院2020年1月-2021年1月收治的83例采用空心钉固定术治疗股骨颈骨折患者的临床资料,统计其术后股骨头坏死发生率,同时分析股骨头坏死发生者和未发生者的基线资料,对可能影响其术后发生股骨头坏死的相关因素进行Logistic多因素分析。结果:83例股骨颈骨折患者空心钉固定术治疗后的股骨头坏死发生率为19.28%。发生股骨头坏死患者和未发生股骨头坏死患者的性别、年龄、手术方式、受伤原因及D-二聚体危险度比较,差异均无统计学意义(P>0.05);骨折Garden分型、慢性肝病、受伤至手术时间及术后负重时间比较,差异均有统计学意义(P<0.05)。Logistic多因素回归分析结果显示骨折Garden分型为Ⅲ和Ⅳ型、合并慢性肝病、受伤至手术时间>7 h是影响空心钉固定术后发生股骨头坏死的独立危险因素(P<0.05)。骨折Garden分型、慢性肝病、受伤至手术时间及术后负重时间和患者术后发生股骨头坏死呈正相关(P<0.05)。结论:对于采用空心钉固定术治疗的股骨颈骨折患者,其术后存在一定股骨头坏死风险,骨折Garden分型为Ⅲ和Ⅳ型、合并慢性肝病、受伤至手术时间>7 h是影响空心钉固定术后发生股骨头坏死的独立危险因素。Objective:To analyze the related factors of femoral head necrosis in patients with femoral neck fracture after hollow screw fixation.Method:A retrospective analysis was performed on the clinical data of 83 patients with femoral neck fracture treated by hollow nail fixation in No.907 Hospital of Joint Service Support Force of the Chinese People’s Liberation Army from January 2020 to January 2021.The incidence of postoperative femoral head necrosis was analyzed,and the baseline data of those with and without femoral head necrosis were analyzed.Logistic multifactor analysis was conducted on the related factors that may affect the occurrence of postoperative femoral head necrosis.Result:The incidence of femoral head necrosis after hollow nail fixation in 83 patients with femoral neck fractures was 19.28%.There were no statistically significant differences in the causes of gender,age,operation method,cause of injury,and D-dimer risk between patients with and without femoral head necrosis(P>0.05).There were statistically significant differences in the fracture garden classification,chronic liver disease,time from injury to operation and postoperative weight-bearing time between patients with and without femoral head necrosis(P<0.05).Logistic multivariate regression analysis showed that the Garden classification of fractures of typeⅢand typeⅣ,combined with chronic liver disease,and the time from injury to operation>7 h were independent risk factors for femoral head necrosis after hollow screw fixation(P<0.05).Garden classification of fracture,chronic liver disease,time from injury to operation and postoperative weight-bearing time were positively correlated with postoperative femoral head necrosis(P<0.05).Conclusion:For patients with femoral neck fractures treated with hollow nail fixation,there is a certain risk of femoral head necrosis after surgery.Garden classification of fractures of typeⅢand typeⅣ,combined with chronic liver disease,and the time from injury to operation>7 h are independent risk factors f

关 键 词：股骨颈骨折 空心钉固定术 股骨头坏死 影响因素 

分 类 号：R687.3[医药卫生—骨科学]