股骨颈骨折保守治疗继发移位及股骨头坏死的调查研究

目的：调查分析股骨颈骨折保守治疗继发移位以及股骨头坏死的情况,并分析其产生原因。方法收集无移位型股骨颈骨折患者356例,按照治疗方式分为两组,176例手术治疗者为手术组,180例保守治疗者为保守组,调查分析两组骨折继发移位以及头坏死发生情况。结果手术的骨折继发移位以及股骨头坏死发生率显著低于保守组（P〈0.05）;保守组继发移位发生股骨头坏死几率显著高于Ⅰ期愈合者,且其发生股骨头坏死的时间较Ⅰ期愈合者显著提前（P〈0.05）。年龄、合并高危并发症、功能锻炼不正确、Pauwels角偏大等均是股骨头坏死的重要原因。结论无移位型股骨颈骨折患者行保守治疗后继发移位以及股骨头坏死的风险较高,早期宜实施手术治疗。

Research of secondary fracture displacement and osteonecrosis after conservative treatment in femoral neck fracture

Objective To investigate the secondary fracture displacement and osteonecrosis after conservative treatment in femoral neck fracture and analyze its causes.Methods 356 patients with nondisplaced femoral neck fracture were divided into two groups according to treatment, 176 cases of surgical treatment for the surgical group, 180 cases of conservative treatment for conservative groups, survey and analysis of secondary fracture displacement and two head necrosis were observed.Results Secondary fracture displacement and the incidence of osteonecrosis in surgical group were significantly lower than the conservative group （P＆lt;0.05）; conservative group of secondary displacement occurred significantly higher risk of osteonecrosis stage I healing, and its occurrence osteonecrosis time than healing I stage was significantly advance （P＆lt;0.05）. Age, combined risk of complications, functional training is not correct, large Pauwels angle all were the major cause of osteonecrosis.Conclusion Conservative treatment for nondisplaced femoral neck fractures in patients with high risk of secondary displacement and head necrosis, early surgical treatment should be implemented.