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閉合復(fù)位空心釘內(nèi)固定治療股骨頸骨折療效的生物力學(xué)分析

Biomechanical analysis of the internal fixation with cannulated screw fixation for femoral neck fractures

作者: 王建光  夏勇  李玉民  劉牛慶  李紅新  韓曉斌  余國(guó)春  黃衛(wèi)國(guó) 
單位:<span style="font-size:14px;font-family:宋體">民航總醫(yī)院骨科(北京</span><span style="font-size:14px;font-family:&#39;Times New Roman&#39;,serif"> 100123</span><span style="font-size:14px;font-family:宋體">)</span>
關(guān)鍵詞: 股骨頸骨折;  空心釘內(nèi)固定;  生物力學(xué)分析;  相關(guān)因素;  Logistic回歸分析 
分類號(hào):R318.01; R683.42
出版年·卷·期(頁(yè)碼):2018·37·3(320-324)
摘要:

目的 通過(guò)閉合復(fù)位空心釘內(nèi)固定治療股骨頸骨折療效的生物力學(xué)分析, 探討影響空心釘內(nèi)固定治療股骨頸骨折療效的主要因素。方法 對(duì)20108月至201610月骨科收治的47例股骨頸骨折患者進(jìn)行回顧性研究。所有股骨頸骨折患者均行閉合復(fù)位空心釘內(nèi)固定治療, 對(duì)性別、年齡、手術(shù)時(shí)機(jī)、術(shù)前牽引、復(fù)位質(zhì)量、術(shù)后完全負(fù)重時(shí)機(jī)、Garden分型、內(nèi)固定是否取出等因素進(jìn)行單因素和多因素分析。結(jié)果 股骨頸骨折療效的危險(xiǎn)因素有:年齡、復(fù)位質(zhì)量 (P<0.05) , 其余指標(biāo)均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論年齡、復(fù)位質(zhì)量是影響股骨頸骨折臨床療效的主要因素, 空心釘內(nèi)固定的力學(xué)固定效應(yīng)為骨折愈合打下良好的基礎(chǔ)。因此在臨床股骨頸骨折的患者可根據(jù)患者的具體情況選擇合適的治療方案, 以取得更好的治療效果。

Objective To investigate the main factors in cannulated srew fixation of femoral neck fractures by the mechanical analysis of the curative effect of the closed reduction and internal fixation of the femoral neck fractures. Methods By August 2010 to October 2016, 47 patients with femoral neck fracture by closed reduction with cannulated screw fixation in our orthopaedic were studied, through single and multiple factor analysis, and the factors concluded the sex, age, operation time, preoperative traction, reduction quality, postoperative full weight-bearing time, Garden Type, removal of internal fixation. Results Logistic regression model of femoral head necrosis risk factors include: age, reduction quality (P < 0. 05) , and the rest are not significant. Conclusions The patient's age, reduction quality were the main factors affecting the femoral neck fracture healing, the mechanical fixation effect of cannulated screw is a good foundation for fracture healing.Therefore, the doctor may select the proper reduction mode according to the patient 's condition for a better therapeutic effect.

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