CAJ | 학술논문

目的评估7.5 mm QWIX螺钉治疗股骨颈骨折的临床疗效并分析术后股骨头缺血坏死的危险因素. 方法 2009年1月-2012年3月收治股骨颈骨折患者53例,行闭合或者切开复位直径7.5 mm QWIX螺钉固定.术后随访股骨颈骨折愈合情况、内固定相关并发症、患侧髋关节Harris评分、股骨头缺血坏死等,并对患者的年龄、性别、致伤原因、骨折类型、术前等待时间、复位方式及骨折复位情况等资料进行单因素分析和多因素Logistic回归分析. 结果所有患者均获得随访2～5年(平均3.4年).所有股骨颈骨折均达到骨性愈合,无螺钉退出、切出股骨头或进入关节腔内.术后2年平均Harris评分为91.2分(68～ 100分),其中优42例,良6例,中1例,差4例,优良率为91％.术后12 ～ 15个月,4例发生股骨头缺血坏死,坏死率为8％.Logistic回归分析发现股骨头缺血坏死与骨折解剖部位分型相关(OR =25.208,P ＜0.01). 结论直径7.5 mm QWIX螺钉治疗股骨颈骨折具有固定稳定,骨折愈合率高、股骨头缺血坏死发生率低等优点,是治疗股骨颈骨折的良好内固定装置.股骨颈骨折术后股骨头缺血坏死与其解剖分型有关.
목적 평고7.5 mm QWIX라정치료고골경골절적림상료효병분석술후고골두결혈배사적위험인소. 방법 2009년1월-2012년3월수치고골경골절환자53례,행폐합혹자절개복위직경7.5 mm QWIX라정고정.술후수방고골경골절유합정황、내고정상관병발증、환측관관절Harris평분、고골두결혈배사등,병대환자적년령、성별、치상원인、골절류형、술전등대시간、복위방식급골절복위정황등자료진행단인소분석화다인소Logistic회귀분석. 결과 소유환자균획득수방2～5년(평균3.4년).소유고골경골절균체도골성유합,무라정퇴출、절출고골두혹진입관절강내.술후2년평균Harris평분위91.2분(68～ 100분),기중우42례,량6례,중1례,차4례,우량솔위91％.술후12 ～ 15개월,4례발생고골두결혈배사,배사솔위8％.Logistic회귀분석발현고골두결혈배사여골절해부부위분형상관(OR =25.208,P ＜0.01). 결론 직경7.5 mm QWIX라정치료고골경골절구유고정은정,골절유합솔고、고골두결혈배사발생솔저등우점,시치료고골경골절적량호내고정장치.고골경골절술후고골두결혈배사여기해부분형유관.
Objective To evaluate the clinical effect of femoral neck fracture fixed with 7.5mm QWIX screws and to find out risk factors for avascular necrosis of the femoral head postoperatively.Methods From January 2009 and March 2013, 53 patients underwent closed or open reduction of femoral neck fracture with 7.5mm QWIX screws.Healing process of fracture, complications of internal fixation, Harris hip score and avascular necrosis of the femoral head were followed up.The data reviewed were age, gender, injury patterns, fracture type, preoperative waiting time, reduction ways, reduction condition, and others.Unilateral and multivariate Logistic analysis were applied to identify factors for avascular necrosis of the femoral head.Results All patients were followed up for 2-5 years (mean, 3.4 years).There was no non-union at follow-up, and all the screws were in the original site without loosening, cut-out or penetration.Mean Harris score was 91.2 points (range, 68 to 100 points) 2 years after operation, including 42 excellent, 6 good, 1 fair and 4 poor results with the excellent-good rate of 91％.Four patients (8％) had avascular necrosis 12 to 15 months after operation.With Logistic regression analysis, fracture anatomic type was identified as the only factor for avascular necrosis of the femoral head.Conclusions The 7.5 mm QWIX fixation screw provides rigid fixation, high healing rate and low incidence of avascular necrosis of the femoral head, appearing to be a good hardware to repair femoral neck fracture.Avascular necrosis of the femoral head is associated with the anatomic type of femoral neck fracture after operation.