SPECT在股骨颈骨折多钉内固定术后股骨头生存分析中的应用

目的初步探讨SPECT在股骨颈骨折空心钉内固定术后股骨头生存分析中的临床应用价值。方法80例单侧股骨颈骨折患者术前均行SPECT检查,根据患侧股骨头/干比值分为A,B2组。A组43例,患侧股骨头/干比值〉2.10,B组37例,患侧股骨头/干比值≤2.10。均行闭合复位中空加压螺丝钉内固定术,术后所有患者均随访2年,对2组的随访资料进行生存分析。结果A组失访3例,2年股骨头生存率为88.4%,股骨头坏死5例（坏死率为12.0%）;B组失访2例,2年股骨头生存率为67.6%,股骨头坏死12例（坏死率为33.3%）;2组生存率比较有显著性差异（P〈0.05）。结论股骨颈骨折后术前早期行SPCET检查对选择治疗方式和股骨颈骨折后的股骨头坏死的预测有重要的临床价值。

The Appliation of SPECT in the Survival Analysis of Femoral Head after Internal Fixation with Cannulated Screws in Femoral Neck Fractures

Objective To primary study the clinical application value of SPECT on the survival analysis after internal fixation with cannulated screws in femoral neck fractures. Methods According the ratio of femoral head-to-shaft, 80 cases femoral neck fractures-unilateral, were divided into two groups：Group A included 43 cases,of which ratio was larger than 2.10 while group B included 37 cases,of which ratio was no more than 2.10. All cases had the internal fixation procedures with cannulated screws and closed reduction. After operation all cases were followed up for two years, and survival rate was analyzed. Results The two year survival rate was 88. 4% in group A,and 67.6% in group B,and the rate of avascular necrosis of femoral head was 12.0%（5 cases） ,33.3% （12 cases） in group A, B respectively, which showed significant difference （P〈 0.05）. Three cases were lost during two-year follow up in group A and 2 in group B. Conclusion Preoperative SPECT after femoral neck fracture had important value on selecting surgical program, and predicting necrosis of femoral head in clinical practice.