股骨转子间骨折患者股骨近端防旋髓内钉术后发生楔形撑开效应的危险因素研究  

Risk factors for wedge-shaped open effect in patients with femoral intertrochanteric fracture after proximal femoral nail antirotation surgery

作　　者：张利鹏 屈福锋 赵小龙[1] 任广铁 ZHANG Li-peng;QU Fu-feng;ZHAO Xiao-long;REN Guang-tie(Department of Trauma and Orthopedics,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,China)

机构地区：[1]汉中市中心医院创伤骨科,陕西汉中723000

出　　处：《川北医学院学报》2024年第11期1512-1515,共4页Journal of North Sichuan Medical College

基　　金：陕西省卫生计生项目(2016C005)。

摘　　要：目的:研究股骨转子间骨折(ITF)患者股骨近端防旋髓内钉(PFNA)术后发生楔形撑开效应的危险因素。方法:回顾性收集200例接受PFNA内固定治疗的ITF患者的病历资料,根据患者术后是否发生楔形撑开效应分为观察组(是,n=18)与对照组(否,n=182)。分析影响ITF患者PFNA术后发生楔形撑开效应的危险因素。结果:观察组年龄、BMI、骨密度<-2.5 SD比例、不稳定型骨折比例、尖顶距均较对照组高,而外侧壁厚度较对照组低(P<0.05);经Logistic回归分析显示,年龄、骨密度<-2.5 SD、不稳定型骨折均为ITF患者PFNA术后发生楔形撑开效应的独立危险因素,而外侧壁厚度为独立保护因素(P<0.05);经ROC曲线分析显示,年龄、骨密度、骨折类型及外侧壁厚度均对ITF患者PFNA术后发生楔形撑开效应具有一定预测价值(P<0.05)。结论:年龄越大、骨密度越低、骨折越不稳定及外侧壁厚度越低,ITF患者PFNA术后发生楔形撑开效应的风险越高。Objective:To investigate the risk factors for wedge-shaped open effect in patients with femoral intertrochanteric fracture(ITF)after proximal femoral nail antirotation(PFNA)surgery.Methods:The clinical data of 200 patients with ITF who underwent PFNA internal fixation were collected retrospectively.The patients were divided into an observation group(with,n=18)and a control group(without,n=182)according to the presence or absence of wedge-shaped open effect after surgery.The risk factors affecting the occurrence of wedge-shaped dilation effect after PFNA surgery in ITF patients were analyzed.Results:Age,BMI,the proportion of bone mineral density<-2.5SD,the proportion of unstable fractures and tip-apex distance in the observation group were higher and greater than those in the control group.The thickness of lateral wall was smaller than that in the control group(P<0.05).Logistic regression analysis results showed that age,bone mineral density<-2.5SD and unstable fracture were independent risk factors for wedge-shaped open effect in patients with ITF after PFNA surgery,while the thickness of lateral wall was an independent protective factor(P<0.05).ROC curve analysis showed that age,bone mineral density,fracture type and the thickness of lateral wall were helpful for predicting wedge-shaped open effect in patients with ITF after PFNA surgery(P<0.05).Conclusion:The higher the age,the lower the bone mineral density,the more unstable the fracture,and the thinner the lateral wall,the higher the risk of wedge-shaped open effect in patients with ITF after PFNA surgery.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 楔形撑开效应 危险因素 

分 类 号：R683.42[医药卫生—骨科学]