青少年股骨颈骨折后股骨头坏死的相关因素分析
发布时间：2019-01-15 21:52
【摘要】：目的国际卫生组织把青少年的年龄范围定为10岁到19岁。[1]青少年股骨颈骨折的发生率很低,但是其术后并发症多且严重,其中股骨头坏死是青少年股骨颈骨折后最严重的的并发症。现在很多文献中都提到一些相关因素与青少年股骨颈骨折后股骨头坏死存在着密切的关系,但还没有明确的大的样本量用统计学数据去证明目前所提出的因果相关性。本文目的就是想确定青少年股骨颈骨折后会发生股骨头坏死,并寻找这些相关因素是否与青少年股骨颈骨折后股骨头坏死存在着因果关系。并将相关危险因素进行多因素分析,用统计学方法去寻找这些危险因素与股骨头坏死之间的关系。根据骨折类型,骨折移位等因素对骨折后股骨头坏死进行风险评估,及给予患者和家属对于风险的咨询。方法回顾分析我院2010年1月至2016年7月收治的63名青少年股骨颈骨折患者,年龄区间为10岁7个月~18岁6个月,随访时间为2到3年。纳入的统计因素有:骨折类型,骨折是否移位,采用的手术方法,术前准备时间。根据影像学结果来确定术后是否发生了股骨头坏死。使用Logistic回归分析骨折类型,骨折移位,术前准备时间,手术方法,这些因素导致股骨头坏死,并在此基础上建立初步相关预测系统,希望能够预测青少年股骨颈骨折后是否会发生股骨头的坏死。结果在此次回顾性分析实验中共收集的63例青少年股骨颈骨折病例里,术后随访中发现有18(28.6%)例发生了股骨头坏死。首次发现术后股骨头发生坏死的时间平均为11个月。多元二分类回归分析显示其中的骨折类型(P=0.048)和骨折移位(P=0.049)在统计学上有意义,与术后股骨头的坏死存在因果关系。而另外两个纳入的相关因素手术方法和术前准备时间,在统计学上没有意义,不是术后导致股骨头坏死的相关危险因素。结论1.骨折类型,骨折移位是青少年股骨颈骨折后股骨头坏死的危险因素。2.伤后1周内行切开复位空心钉内固定和闭合复位空心钉内固定的手术方式和术前准备时间不是青少年股骨颈骨折后股骨头坏死的危险因素。
[Abstract]:Objective the International Health Organization defines the age range of adolescents as 10 to 19 years old. [1] the incidence of femoral neck fractures in adolescents is very low, but the complications are numerous and serious. Osteonecrosis of femoral head is the most serious complication after femoral neck fracture in adolescents. There is a close relationship between some related factors and osteonecrosis of femoral head after femoral neck fracture in adolescents, but there is no clear large sample size to prove the causality. The purpose of this paper is to determine whether there is a causal relationship between the necrosis of the femoral head and the necrosis of the femoral head after the fracture of the femoral neck in the adolescent and to find out whether there is a causal relationship between these factors and the necrosis of the femoral head after the fracture of the femoral neck in adolescents. The relationship between these risk factors and femoral head necrosis was analyzed by multivariate analysis. The risk of femoral head necrosis after fracture was evaluated according to fracture type, fracture displacement and so on, and patients and family members were consulted on the risk. Methods from January 2010 to July 2016, 63 young patients with femoral neck fracture were retrospectively analyzed. The age range was 10 years, 7 months to 18 years, 6 months, followed up for 2 to 3 years. The statistical factors included: fracture type, fracture displacement, operative method and preoperative preparation time. Imaging results were used to determine whether necrosis of the femoral head occurred after surgery. Using Logistic regression analysis of fracture type, fracture displacement, preoperative preparation time, operative method, these factors resulted in femoral head necrosis, and based on these factors, a preliminary correlation prediction system was established. We hope to predict whether necrosis of femoral head will occur after juvenile femoral neck fracture. Results in this retrospective analysis of 63 cases of juvenile femoral neck fracture, 18 (28.6%) cases of femoral head necrosis were found in the follow-up. The average time for the first time to find necrosis of the femoral head after operation was 11 months. Multiple binary regression analysis showed that the fracture type (P0. 048) and fracture displacement (P0. 049) were statistically significant and had a causal relationship with postoperative necrosis of the femoral head. The other two related factors, the operative method and the preoperative preparation time, were not statistically significant and were not the risk factors for femoral head necrosis after operation. Conclusion 1. Fracture type, fracture displacement is the risk factor of femoral head necrosis after femoral neck fracture in adolescents. 2. Open reduction and hollow nail internal fixation and closed reduction and hollow nail internal fixation were not the risk factors of femoral head necrosis after femoral neck fracture in adolescents within 1 week after injury.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.8
本文编号：2409144
[Abstract]:Objective the International Health Organization defines the age range of adolescents as 10 to 19 years old. [1] the incidence of femoral neck fractures in adolescents is very low, but the complications are numerous and serious. Osteonecrosis of femoral head is the most serious complication after femoral neck fracture in adolescents. There is a close relationship between some related factors and osteonecrosis of femoral head after femoral neck fracture in adolescents, but there is no clear large sample size to prove the causality. The purpose of this paper is to determine whether there is a causal relationship between the necrosis of the femoral head and the necrosis of the femoral head after the fracture of the femoral neck in the adolescent and to find out whether there is a causal relationship between these factors and the necrosis of the femoral head after the fracture of the femoral neck in adolescents. The relationship between these risk factors and femoral head necrosis was analyzed by multivariate analysis. The risk of femoral head necrosis after fracture was evaluated according to fracture type, fracture displacement and so on, and patients and family members were consulted on the risk. Methods from January 2010 to July 2016, 63 young patients with femoral neck fracture were retrospectively analyzed. The age range was 10 years, 7 months to 18 years, 6 months, followed up for 2 to 3 years. The statistical factors included: fracture type, fracture displacement, operative method and preoperative preparation time. Imaging results were used to determine whether necrosis of the femoral head occurred after surgery. Using Logistic regression analysis of fracture type, fracture displacement, preoperative preparation time, operative method, these factors resulted in femoral head necrosis, and based on these factors, a preliminary correlation prediction system was established. We hope to predict whether necrosis of femoral head will occur after juvenile femoral neck fracture. Results in this retrospective analysis of 63 cases of juvenile femoral neck fracture, 18 (28.6%) cases of femoral head necrosis were found in the follow-up. The average time for the first time to find necrosis of the femoral head after operation was 11 months. Multiple binary regression analysis showed that the fracture type (P0. 048) and fracture displacement (P0. 049) were statistically significant and had a causal relationship with postoperative necrosis of the femoral head. The other two related factors, the operative method and the preoperative preparation time, were not statistically significant and were not the risk factors for femoral head necrosis after operation. Conclusion 1. Fracture type, fracture displacement is the risk factor of femoral head necrosis after femoral neck fracture in adolescents. 2. Open reduction and hollow nail internal fixation and closed reduction and hollow nail internal fixation were not the risk factors of femoral head necrosis after femoral neck fracture in adolescents within 1 week after injury.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.8
【参考文献】
相关期刊论文 前1条
1 吴守义;王晓林;杨文毅;汪启筹;杨根兴;;儿童股骨颈骨折[J];中华骨科杂志;1989年03期
，本文编号：2409144
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