青少年股骨頸骨折后股骨頭壞死的相關(guān)因素分析
發(fā)布時(shí)間：2019-01-15 21:52
【摘要】：目的國(guó)際衛(wèi)生組織把青少年的年齡范圍定為10歲到19歲。[1]青少年股骨頸骨折的發(fā)生率很低,但是其術(shù)后并發(fā)癥多且嚴(yán)重,其中股骨頭壞死是青少年股骨頸骨折后最嚴(yán)重的的并發(fā)癥。現(xiàn)在很多文獻(xiàn)中都提到一些相關(guān)因素與青少年股骨頸骨折后股骨頭壞死存在著密切的關(guān)系,但還沒有明確的大的樣本量用統(tǒng)計(jì)學(xué)數(shù)據(jù)去證明目前所提出的因果相關(guān)性。本文目的就是想確定青少年股骨頸骨折后會(huì)發(fā)生股骨頭壞死,并尋找這些相關(guān)因素是否與青少年股骨頸骨折后股骨頭壞死存在著因果關(guān)系。并將相關(guān)危險(xiǎn)因素進(jìn)行多因素分析,用統(tǒng)計(jì)學(xué)方法去尋找這些危險(xiǎn)因素與股骨頭壞死之間的關(guān)系。根據(jù)骨折類型,骨折移位等因素對(duì)骨折后股骨頭壞死進(jìn)行風(fēng)險(xiǎn)評(píng)估,及給予患者和家屬對(duì)于風(fēng)險(xiǎn)的咨詢。方法回顧分析我院2010年1月至2016年7月收治的63名青少年股骨頸骨折患者,年齡區(qū)間為10歲7個(gè)月~18歲6個(gè)月,隨訪時(shí)間為2到3年。納入的統(tǒng)計(jì)因素有:骨折類型,骨折是否移位,采用的手術(shù)方法,術(shù)前準(zhǔn)備時(shí)間。根據(jù)影像學(xué)結(jié)果來(lái)確定術(shù)后是否發(fā)生了股骨頭壞死。使用Logistic回歸分析骨折類型,骨折移位,術(shù)前準(zhǔn)備時(shí)間,手術(shù)方法,這些因素導(dǎo)致股骨頭壞死,并在此基礎(chǔ)上建立初步相關(guān)預(yù)測(cè)系統(tǒng),希望能夠預(yù)測(cè)青少年股骨頸骨折后是否會(huì)發(fā)生股骨頭的壞死。結(jié)果在此次回顧性分析實(shí)驗(yàn)中共收集的63例青少年股骨頸骨折病例里,術(shù)后隨訪中發(fā)現(xiàn)有18(28.6%)例發(fā)生了股骨頭壞死。首次發(fā)現(xiàn)術(shù)后股骨頭發(fā)生壞死的時(shí)間平均為11個(gè)月。多元二分類回歸分析顯示其中的骨折類型(P=0.048)和骨折移位(P=0.049)在統(tǒng)計(jì)學(xué)上有意義,與術(shù)后股骨頭的壞死存在因果關(guān)系。而另外兩個(gè)納入的相關(guān)因素手術(shù)方法和術(shù)前準(zhǔn)備時(shí)間,在統(tǒng)計(jì)學(xué)上沒有意義,不是術(shù)后導(dǎo)致股骨頭壞死的相關(guān)危險(xiǎn)因素。結(jié)論1.骨折類型,骨折移位是青少年股骨頸骨折后股骨頭壞死的危險(xiǎn)因素。2.傷后1周內(nèi)行切開復(fù)位空心釘內(nèi)固定和閉合復(fù)位空心釘內(nèi)固定的手術(shù)方式和術(shù)前準(zhǔn)備時(shí)間不是青少年股骨頸骨折后股骨頭壞死的危險(xiǎn)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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R726.8
本文編號(hào)：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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R726.8
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 吳守義;王曉林;楊文毅;汪啟籌;楊根興;;兒童股骨頸骨折[J];中華骨科雜志;1989年03期
，本文編號(hào)：2409144
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