下地时间对股骨颈骨折后股骨头坏死的影响

目的：探讨股骨颈骨折后股骨头缺血性坏死的发生与手术后下地不负重活动时间的关系，为手术后正确指导患者功能锻炼提供理论依据。方法：对我院1996年1月～2003年10月收治的278例股骨颈骨折行内固定治疗的病例进行了5～10年的随访。根据患者术后下地时间分为3月内下地组（82例）、3-6月下地组（100例）以及6月后下地组（96例），分析比较各组间股骨头坏死发生率，并进行统计学分析。结果：共发生股骨头坏死86例，发生率31％。其中3月内下地组34例，发生率41．5％；3~6月下地组27例，发生率27％；6月后下地组25例，发生率26．0％。根据统计学分析，手术后3月内股骨头坏死发生率明显高于其它2组（P〈0．05），而3-6月下地组和6月后下地组之间股骨头坏死发生率无显著性差异。结论：股骨颈骨折术厉股骨头坏死的发生随手术后下地时间的不同而不同，其中手术后3-6个月之间下地不负重活动，更有利于患者功能的恢复。

The Relation Between Unloaded Activity and Femoral Head Necrosis After Operation of Femoral Neck Fracture

Objective： To discuss the relationship between unloaded activity and femoral head necrosis after operation of femoral neck fracture, and to provide theoretic basis for the proper exercise after operation. Methods： From January 1996 to May 2001, 278 cases of femoral neck fracture were randomly divided into three groups according to their unloaded ac, tivity time after operation, unloaded activity beibre 3 months （3-month-group）, 3-6 months （3~6-month-group）, and after 6 months （6-month-group）. Then analyze and compare the incidence rate of femoral head necrosis in each group. SPSS11.0 Stat. software was used to analyze the result. Results： All cases were followed-up for 5-10 years, there are 86 cases, including 34 cases in 3-month-group （41.5%）, 27 cases in 3-6-month-group （27%） and 25 cases in 6-month-group （25%） occurred femoral head necrosis, the total necrosis rate was 31%. The necrosis rate of 3-month-group was higher than other groups （P〈0.05）after statistics analysis. The necrosis rate between 3-6-month-group and 6-month-group was insignificant （P〉0.05）. Conclusion： The rate of femoral head necrosis after the femoral neck fracture differ with the vary time of unloaded activity. Among them, unloaded activity between 3 and 6 months was the best way to restitute their functional.