联合偏转角内收型分型与股骨颈骨折内固定术后并发症的相关性研究  

Correlation between combined deflection angle classification adduction typing and complications after internal fixation of adduction femoral neck fracture

作　　者：董一平 骆聪聪 张宁 尤若楠 袁强 李无阴 张颖 DONG Yiping;LUO Congcong;ZHANG Ning;YOU Ruonan;YUAN Qiang;LI Wuyin;ZHANG Ying(Graduate School of Henan University of Traditional Chinese Medicine,Zhengzhou Henan,450046,P.R.China;The Fifth Department of Hip Joint,Luoyang Orthopedic-Traumatological of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang Henan,471002,P.R.China;Graduate School of Hunan University of Traditional Chinese Medicine,Changsha Hunan,410208,P.R.China)

机构地区：[1]河南中医药大学研究生院,郑州450046 [2]河南省洛阳正骨医院(河南省骨科医院)髋关节外五科,河南洛阳417002 [3]湖南中医药大学研究生院,长沙410208

出　　处：《中国修复重建外科杂志》2024年第4期405-411,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81774348、81874477);河南省卫生健康中青年学科带头人资助项目(HNSWJW-2020028);河南省科技攻关项目(202102310152)。

摘　　要：目的探讨联合偏转角内收型(combined deflection angle classification adduction type,CDACADT)分型与股骨颈骨折经空心螺钉内固定术后并发症之间的相关性。方法回顾分析2018年1月—2021年12月收治且符合选择标准的121例CDAC-ADT股骨颈骨折患者临床资料。男69例,女52例;年龄19~79岁,平均48.1岁。致伤原因:交通事故伤52例,高处坠落伤24例,摔伤45例。受伤至手术时间2~12 d,平均6.0 d。其中CDAC-ADTⅠ型18例、Ⅱ型46例、Ⅲ型57例;Garden分型Ⅱ型6例、Ⅲ型103例、Ⅳ型12例;按骨折线位置分型,头下型26例、经颈型88例、基底型7例。均采用空心螺钉内固定治疗。记录患者并发症(包括内固定失败、骨折不愈合与股骨头坏死)发生情况,并分析并发症与CDAC-ADT分型、Garden分型、骨折线位置之间的相关性。结果患者均获随访,随访时间8~44个月,平均24.9个月。术后共发生内固定失败10例、骨折不愈合7例、股骨头坏死30例。相关性分析示,患者CDAC-ADT分型与总体并发症发生、内固定失败、骨折不愈合、股骨头坏死均具有相关性(P<0.05),Pearson列联系数r分别为0.435、0.251、0.254、0.241;Garden分型与总体并发症发生、内固定失败、骨折不愈合无相关性(P>0.05),与股骨头坏死具有相关性(P<0.05),Pearson列联系数r为0.251。骨折线位置分型与总体并发症发生及内固定失败、骨折不愈合、股骨头坏死均无相关性(P>0.05)。结论CDAC-ADT分型与股骨颈骨折术后并发症存在明显相关性,可用于股骨颈骨折术后并发症的预测。Objective To analyze the correlation between postoperative complications and combined deflection angle classification adduction type(CDAC-ADT)of femoral neck fractures after cannulated screw internal fixation.Methods The clinical data of 121 patients with CDAC-ADT femoral neck fracture admitted between January 2018 and December 2021 and met the selected criteria were retrospectively analyzed.There were 69 males and 52 females,the age ranged from 19 to 79 years(mean,48.1 years).The causes of injury included 52 cases of traffic accident,24 cases of falling from height,and 45 cases of fall.The time from injury to operation ranged from 2 to 12 days,with an average of 6.0 days.Among them,there were 18 cases of CDAC-ADT typeⅠ,46 cases of typeⅡ,and 57 cases of typeⅢ;6 cases of Garden typeⅡ,103 cases of typeⅢ,and 12 cases of typeⅣ;and according to the location of the fracture line,there were 26 cases of subcapitate type,88 cases of transcervical type,and 7 cases of basal type.All patients were treated with cannulated screw internal fixation.The occurrence of complications(including internal fixation failure,fracture nonunion,and osteonecrosis of the femoral head)was recorded,and the correlation between complications and CDAC-ADT typing,Garden typing,and fracture line location were analyzed.Results The patients were followed up 8-44 months,with a mean of 24.9 months.There were 10 cases of internal fixation failure,7 cases of fracture nonunion,and 30 cases of osteonecrosis of the femoral head after operation.Correlation analysis showed that patients’CDAC-ADT typing was significantly correlated with the overall incidence of complication and the incidence of internal fixation failure,fracture nonunion,and osteonecrosis of the femoral head(P<0.05),and the Pearson coefficient of contingency were 0.435,0.251,0.254,and 0.241,respectively.Garden typing did not correlate with the overall incidence of complication and the incidence of internal fixation failure and fracture nonunion(P>0.05),but correlated with the inci

关 键 词：股骨颈骨折 并发症 联合偏转角 GARDEN分型 骨折线位置 

分 类 号：R687.3[医药卫生—骨科学]