罗建民　许　斌　朱求亮浙江省安吉县人民医院骨科，浙江安吉　313300

老年股骨颈骨折内固定术后患者股骨头缺血性坏死的相关因素

罗建民许斌朱求亮
浙江省安吉县人民医院骨科，浙江安吉313300

目的探讨老年股骨颈骨折内固定术后患者股骨头缺血性坏死的相关因素。方法 将2012年11月～2014年11月我院收治的120例老年股骨颈骨折患者作为研究对象，所有患者均行内固定术，观察术后患者股骨头缺血性坏死的发生情况，并对造成患者股骨头缺血性坏死的因素进行相关性分析。结果 术后随访6～24个月（平均10.5个月），39例患者在术后出现股骨头缺血性坏死的并发症，并发症发生率为32.5%；术后未发生股骨头缺血性坏死患者的股骨颈扭转角（31.56±8.81）°与前倾角（13.75±3.41）°均明显小于术后发生股骨头缺血性坏死患者的股骨颈扭转角（45.04±12.25）°与前倾角（21.24±6.32）°，差异有统计学意义（t=6.88、8.44，P＜0.05）；年龄、性别、致伤到手术时间、Garden分型等因素是术后是否并发股骨头缺血性坏死的相关因素（r=0.038、-0.032、-0.023、0.054，P＜0.05）。结论 内固定术是一种治疗股骨颈骨折分型的有效治疗方案，经过治疗，术后易出现股骨头缺血性坏死并发症，年龄、性别、致伤到手术时间、Garden分型等因素是术后是否并发股骨头缺血性坏死的相关因素。

老年；股骨颈骨折；内固定术；股骨头缺血性坏死；股骨颈扭转角与前倾角

［Abstract］Objective To analyze and discuss the related factors of avascular necrosis of femoral head（ANFH）after internal fixation of femoral neck fracture in elderly patients.Methods 120 elderly patients with femoral neck fracture treated in our hospital from November 2012 to November 2014 were selected.All patients were given internal fixation. The incidence of ANFH was observed after operation，and related factors were analyzed.Results The patients were followed up for 6-24 months（10.5 in average）.ANFH was observed in 39 patients，with an incidence rate of 32.5%.The femoral torsion angle（31.56±8.81）°and anteversion angle（13.75±3.41）°in patients without ANFH were significantly smaller than those in patients with ANFH［（45.04±12.25）°and（21.24±6.32）°，respectively；t=6.88，8.44，P＜0.05］.Ages，genders，time from injury to operation，Garden classification，femoral torsion angle，and anteversion angle were related factors of ANFH after operation（r=0.038，-0.032，-0.023，and 0.054，P＜0.05）.Conclusion Internal fixation is an effective treatment for femoral neck fracture.After treatment，the living quality of patients is significantly improved.However，ANFH is commonly observed as a complication after operation，with related factors including ages，genders，time from injury to operation，Garden classification，femoral torsion angle，and anteversion angle.

［Key words］Elderly；Femoral neck fracture；Internal fixation；Avascular necrosis of femoral head；Femoral torsion angle and anteversion angle

老年股骨颈骨折多由于交通事故和摔伤所导致，尤其是冬天，天冷路滑，加之老年人易摔伤，大大增加了股骨颈骨折的发生率［1］。股骨颈骨折主要由骨质疏松引起，患者需要卧床休息以重建骨骼连续性［2］。……