| 摘要: |
| 目的:探讨股骨颈骨折患者内固定术后致股骨头坏死的相关影响因素。方法:对上海市第六人民医院1999年5月至2004年4月期间收治的患者,进行术后门诊随访和通讯手段随访相结合的形式获得有完整随访资料者99例,运用SPSS 14.0建立数据库,并进行统计分析。结果:到2006年1月为止,99例患者术后随访共有15例出现坏死,坏死率为15.2%。交互作用分析得出:年龄与内固定是否取出、性别与复位时间存在交互作用；单因素Logistic回归分析得出:年龄、骨折是否移位、复位质量和内固定是否取出是影响因素；多因素Logistic逐步回归分析得出:年龄、年龄与内固定是否取出、复位质量是股骨头坏死的相关影响因素；多因素Logistic逐步回归后的精细分析得出:56~85岁患者中,内固定取出组股骨头坏死是未取出组的26.00倍(95%CI=3.076~219.747)。结论:股骨颈骨折患者内固定术手术时年龄越大,越不易并发股骨头坏死；对于老年患者,取出内固定可能会增加股骨头坏死和塌陷的风险；解剖复位有助于降低内固定术后股骨头坏死的发生率。 |
| 关键词: 股骨颈骨折 股骨头坏死 危险因素；回归分析 |
| DOI：10.3724/SP.J.1008.2008.01350 |
| 投稿时间：2008-05-14修订日期：2008-10-09 |
| 基金项目:上海市医学人才领军计划(LJ06053). |
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| Factors affecting avascular necrosis of femoral head after internal fixation with cannulated screws in femoral neck fractures |
| AI Zi-sheng1,ZHANG Chang-qing2*,LIU Yue3 ,WANG Gang2,CHEN Sheng-bao2 |
| (1.Department of Preventive Medicine,Medical College,Tongji University,Shanghai 200092,China;2.Department of Orthopaedics,Sixth People’s Hospital of Shanghai,Shanghai Jiaotong University,Shanghai 200233;3.Department of Orthopaedics,Gongli Hospital,Pudong New Area,Shanghai 200135) |
| Abstract: |
| Objective:To investigate the factors influencing the avascular necrosis of femoral head after internal fixation of femoral neck fracture.Methods: A total of 99 patients with femoral neck fracture,who were treated with internal fixation between May 1999 and April 2004,were followed up in outpatient Department and by telephone.The data was set up and analyzed by SPSS 14.0 software.Results: Until January 2006,avascular necrosis of the femoral head was found in 15 cases (15.2%).Age×internal fixation,gender×the time of reduction were found interactive in two factors interactive analysis.Age,the displacement of fractures,the quality of reduction,and internal fixation were found to be significant factors in single factor logistic regression analysis.Age,age×internal fixation,and the quality of reduction were found to be significant factors in multivariate logistic regression analysis.In fine analysis of interactive after multivariate logistic regression analysis,the removal of internal fixation was the most important risk factor for femoral head necrosis in 56-85yrs group,with the risk ratio being 26.00(95%CI=3.076-219.747).Conclusion: Elder patients have less chance for avascular necrosis of femoral head.The extraction of cannulated screws might lead to more avascular necrosis of femoral head and collapse in old patients.Dissection reduction can help to reduce avascular necrosis. |
| Key words: femoral neck fractures femur head necrosis risk factors regression analysis |
