股骨颈骨折闭合复位空心加压螺钉内固定术后股骨头坏死的影响因素分析

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摘要目的分析股骨颈骨折闭合复位空心加压螺钉内固定术后股骨头坏死的影响因素。方法根据纳入标准选择118例股骨颈骨折行闭合复位空心加压螺钉内固定的患者，分别对年龄、性别、民族、骨折Garden分型、手术时机、Garden对线指数、甘油三酯、总胆固醇及低密度脂蛋白9个因素进行统计学分析，分析这些因素与内固定术后股骨头坏死之间的关系。结果根据对9个因素进行单因素分析，其中民族、总胆固醇对股骨颈骨折内固定术后股骨头坏死无统计学意义，而年龄、性别、骨折Garden分型、手术时机、Garden对线指数、甘油三酯、低密度脂蛋白则有统计学意义；将单因素分析有意义的纳入二分类Logistic回归，其中性别、甘油三酯无统计学意义，而年龄、骨折Garden分型、手术时机、Garden对线指数、低密度脂蛋白则有统计学意义。结论对于股骨颈骨折患者，年龄、骨折Garden分型、手术时机、Garden对线指数、低密度脂蛋白是股骨颈骨折闭合复位空心加压螺钉内固定术后股骨头坏死的危险因素。

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关键词 ：股骨颈骨折, 空心加压螺钉, 股骨头坏死, 危险因素

Abstract：Objective To analyze the influencing factors of femoral head necrosis after closed reduction and internal with cannulated compression screws of femoral neck fracture.Methods A total of 118 patients with femoral neck fractures underwent closed reduction and cannulated compression screws were selected according to the inclusion criteria.Statistical analysis was performed on 9 factors including age，gender，ethnicity，fracture Garden classification，timing of surgery，Garden's alignment index，triglyceride，total cholesterol and low density lipoprotein，and analyzed the relationship between femoral head necrosis and closed reduction and internal withcannulatedcompression screws of femoral neck fracture.Results According to the t-test or chi-square test of 9 factors，there was no statistical significance of femoral head necrosis after femoral neck fracture internal fixation with ethnicity and total cholesterol.Age，gender，fracture Garden classification，timing of surgery，Garden's alignment index，triglyceride，lowdensity lipoprotein were statistically significant.According to binary logisticanalysis，gender，triglyceride was not statistically significant，but age，Garden classification，timing of surgery，Garden's alignment index，low density lipoprotein has statistical significance.Conclusion For femoral neck fractures，age，fracture Garden classification，timing of surgery，Garden'salignment index，and lowdensity lipoprotein are risk factors for femoral head necrosis after closed reduction and internal withcannulatedcompression screws of femoral neck fracture.

Key words： femoral neck fractures cannulated compression screws femoral head necrosis riskfactor

基金资助:国家自然科学基金(81760398)

通讯作者: 阿斯哈尔江·买买提依明

作者简介: 王添兴(1991－ )，男，研究生在读，新疆医科大学，新疆医科大学第一附属医院关节外科，830054。

引用本文:

王添兴 1，2，李国庆 1，2，汪洋 1，2，纪保超 1，2，阿斯哈尔江·买买提依明 1，2*. 股骨颈骨折闭合复位空心加压螺钉内固定术后股骨头坏死的影响因素分析[J]. 实用骨科杂志, 2019, 25(2): 105-112.
Wang Tianxing 1，2，Li Guoqing 1，2，Wang Yang 1，2，et al. Analysis of Influencing Factors of Femoral Head Necrosis after Closed Reduction and Internal Fixationwith Cannulated Compression Screws. sygkzz, 2019, 25(2): 105-112.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2019/V25/I2/105

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