摘要
目的探讨缝匠肌骨瓣加内固定治疗青壮年股骨颈骨折术后股骨头坏死发生的影响因素。方法回顾性分析从2005年2月至2015年1月我院采用空心钉内固定加缝匠肌髂骨瓣移植治疗的青壮年股骨颈骨折患者113例,其中男64例,女49例;年龄21~50岁,平均36.3岁。按患者末次随访时是否发生股骨头坏死分为非股骨头坏死组和股骨头坏死组,根据患者的临床资料以及影像学资料,选用可能与术后股骨头坏死发生相关的因素如性别、年龄、受伤至手术时间、骨折Garden分型、手术时间、手术复位情况、术后开始负重时间以及内固定是否取出等8个因素,对这些因素分别给予分组、统计和赋值,采用单因素卡方检验去除无关因素后进行多因素Logistic回归分析。结果113例患者获得23~105个月的随访,末次随访时共23例患者发生股骨头坏死。对上述8个因素进行单因素χ2检验分析,两组间骨折Garden分型、手术时间、手术复位情况的差异有统计学意义(P<0.05),其他因素组间差异无统计学意义(P>0.05)。对这3个有统计学意义的因素进行多因素Logistic回归分析,表明手术复位情况是股骨头坏死发生的独立危险因素。结论受伤后骨折的类型事先影响缝匠肌骨瓣加内固定治疗青壮年股骨颈骨折术后是否发生股骨头坏死。手术医生争取一次复位成功以缩短手术时间,提高骨折复位质量,可减少股骨头坏死的发生率。
Objective To explore factors related to occurrence of osteonecrosis of femur head after femur neck fracture with the treatment of hollow screws and sartorius iliac flap transplant.Methods A total of 113 patients of femur neck fractures treated by hollow screws and sartorius iliac flap transplant between February 2005 and January 2015 were analyzed in our hospital.Patients were divided into non-osteonecrosis of femur head group and osteonecrosis of femur head group according to the occurrence of osteonecrosis of femur head at last follow-up.According to clinical information and imaging data,we selected some factors such as gender,age,time from injury to operation,Garden type of fracture,operation time,quality of reduction,weight bearing time and removal of screws,which may affect the occurrence of osteonecrosis of femur head after operation.The selected factors were grouped and assigned.After excluding unrelated factorsby one-way chi-square test analysis,multivariable Logistic regression ereused to analyze the data.Results 113 patients were followed up for 23-105 months.A total of 23 patients had osteonecrosis of femur head occurred at last follow-up.After one-way chi-square test analysis to the above 8 factors,there was statistic significance between groups about Garden type of fracture,operation time and quality of reduction（P〈0.05）,and there was no statistic significance about other factors（P〉0.05）.Multiariable Logistic regression analysis showed,Garden type of fracture was the independent influencing factor for occurrence of osteonecrosis of femur head after femur neck fracture with the treatment of hollow screws and sartorius iliac flap transplant.Conclusion Type of fracture after injury initially affectsoccurrence of osteonecrosis of femur head after femur neck fracture with the treatment of hollow screws and sartorius iliac flap transplant.Reduction at the first time and reduced operation timecanimproving quality of reduction and reduce the rate of occurrence of osteonecrosis of femur head.
出处
《实用骨科杂志》
2017年第7期604-608,共5页
Journal of Practical Orthopaedics
关键词
股骨颈骨折
股骨头坏死
缝匠肌髂骨瓣
LOGISTIC回归
femur neck fracture
osteonecrosis of femur head
sartorius iliac flap
logistic regression analysis
