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股骨颈骨折术后股骨头坏死的影像学及发病因素分析 被引量:1

Imaging of osteonecrosis after closed reduction and internal fixation and the risk factors
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摘要 目的调查股骨颈骨折闭合复位加压内固定术后股骨头坏死的影像学表现,分析其发病因素。方法回顾性分析2006年2月至2013年3月期间接受闭合复位内固定治疗的782例股骨颈骨折患者。平均随访(6.3±2.4)年,筛选出术后出现股骨头坏死的患者132例,使用Ficat分期标准对患者进行影像学表现分期,将患者的年龄、性别、伤侧、骨折复位满意度等基本资料运用Logistic回归进行多因素分析。结果不同年龄组股骨头坏死的Ficat分期差异有统计学意义(CMH统计量为4.321,P=0.026);男、女的Ficat分期分布情况差异无统计学意义(CMH统计量为1.532,P=0.224)。多因素回归分析显示骨折的移位程度、骨折复位质量与股骨头坏死明显相关(OR分别为2.327,4.213)。结论闭合复位加压螺纹钉内固定治疗股骨颈骨折效果较好,骨折移位程度及骨折复位质量对术后股骨头坏死的发生有明显的影响。 Objective To investigate the imaging of osteonecrosis after closed reduction and internal fixation and the risk factors.Methods A retrospective analysis was performed on 782 cases from our hospital during the period February 2006 to March 2013 who accepted the closed reduction and internal fixation of femoral neck fracture.Mean follow-up period was(6.3±2.4)years,and 132 cases of femoral head necrosis were screened postoperatively.Ficat staging criteria were used for imaging stage.Multivariate logistic regression was carried out to analyze age,sex,injured side,satisfaction of fractures reduction.Results There was significant difference in Ficat stage among different age groups(CMH statistic 4.321,P=0.026).Ficat staging distribution in men and women showed no significant difference(CMH statistic 1.532,P=0.224).Multivariate logistic regression analysis revealed that the degree of fracture displacement and fractures quality were significantly associated with osteonecrosis(OR=2.327,and 4.213).Conclusion Closed reduction and compression screw fixation for femoral neck fracture can obtain satisfactory effects,and the degree of fracture displacement and fractures quality exert a significant impact on postoperative femoral head necrosis.
作者 王良勇
出处 《骨科》 CAS 2014年第2期95-97,共3页 ORTHOPAEDICS
关键词 股骨颈骨折 股骨头坏死 外科手术 计算机辅助 Femoral neck fractures Femur head necrosis Surgery computer-assisted
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