摘要
目的分析创伤性股骨颈骨折患者内固定术后发生股骨头坏死的相关危险因素。方法回顾性分析2019年3月至2021年3月本院骨科收治的68例创伤性股骨颈骨折患者的临床资料,所有患者均行内固定术治疗,收集患者性别、年龄、骨折分型、首次负重时间、术前是否牵引、固定物取出、囊内减压、复位质量等临床资料,采用多因素Logistic线性回归分析股骨颈骨折术后股骨头坏死的危险因素。结果内固定术后随访1年,68例患者中54例(79.41%)已愈合或接近愈合,未发生严重并发症或不良反应;14例(20.59%)术后发生股骨头坏死。术后发生与未发生股骨头坏死患者性别、首次负重时间、术前是否牵引、固定物取出、囊内减压比较差异无统计学意义;术后发生与未发生股骨头坏死患者患者年龄、骨折分型、治疗时机和复位质量比较差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,年龄、骨折分型、治疗时机、复位质量是导致股骨头坏死发生的独立危险因素(P<0.05)。结论创伤性股骨颈骨折患者内固定术后股骨头坏死发生率较高,年龄、骨折分型、治疗时机、复位质量是导致股骨头坏死发生的主要危险因素,临床治疗中应对各项影响因素给予重视,将其作为判断股骨头坏死发生的观察指标。
Objective Analysis of risk factors for femoral head necrosis after internal fixation in patients with traumatic femoral neck fractures.Methods The clinical data of 68 patients with traumatic femoral neck fractures admitted to our orthopedic department from March 2019 to March 2021 were retrospectively analyzed,all patients were treated with internal fixation,and the clinical data such as gender,age,fracture subtype,time of first weight bearing,whether traction was applied preoperatively,fixation removal,intracapsular decompression,and quality of repositioning were collected,and multivariate Logistic regression analysis was used to analyze the risk factors of femoral head necrosis after femoral neck fracture surgery.Results At 1-year follow-up after internal fixation,54 of 68 patients(79.41%)who had healed or were close to healing without serious complications or adverse reactions;14 patients(20.59%)who had femoral head necrosis after surgery.There was no statistically significant difference between the two categories of patients in terms of gender,time of first weight-bearing,preoperative traction or not,fixation removal,and intracapsular decompression between patients with and without postoperative femoral head necrosis;there was statistically significant difference in terms of age,fracture typing,timing of treatment,and quality of reduction between patients with and without postoperative femoral head necrosis(P<0.05).Multivariate Logistic regression analysis showed that age,fracture typing,timing of treatment,and quality of repositioning were independent risk factors for the occurrence of femoral head necrosis(P<0.05).Conclusion The incidence of femoral head necrosis after internal fixation in patients with traumatic femoral neck fractures is high,age,fracture fractionation,timing of treatment,and quality of repositioning are the main risk factors for the occurrence of femoral head necrosis,and each influencing factor should be paid attention to in clinical treatment as an observation index to determine the occurrence of femoral head necrosis.
作者
李俊博
蔡正生
李吉祥
LI Junbo;CAI Zhengsheng;LI Jixiang(Department of Comprehensive Surgery,Shenyang Orthopedic Hospital,Shenyang,Liaoning,110000,China)
出处
《当代医学》
2023年第11期85-88,共4页
Contemporary Medicine
关键词
创伤性股骨颈骨折
内固定术
股骨头坏死
危险因素
Traumatic femoral neck fracture
Internal fixation
Femoral head necrosis
Risk factors
