Influential factors on femoral head avascular necrosis after screw internal fixation for femoral neck fracture of Pauwels type III

doi:10.3969/j.issn.2095-4344.1947

Abstract

Abstract:

BACKGROUND: In recent years, the incidence of Pauwels type III fractures has increased, and the treatment plan is not clear, and the avascular necrosis of femoral head is easy to occur after surgery compared with Pauwels type I and II fractures. Analysis of related risk factors is of great significance for preventing avascular necrosis of femoral head after surgery.

OBJECTIVE: To evaluate the influential factors for femoral head avascular necrosis after screw internal fixation for femoral neck fracture of Pauwels type III.

METHODS: Clinical data of 216 patients with Pauwels type III femoral neck fracture who were admitted to Zhongshan Hospital of Traditional Chinese Medicine from January 2010 to December 2016 were analyzed retrospectively. Risk factors related to femoral head avascular necrosis after screw internal fixation were evaluated by univariate and multivariate logistic regression analysis. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee.

RESULTS AND CONCLUSION: (1) In 216 patients with femoral neck fracture of screw fixation, the incidence of the femoral head avascular necrosis was 12.5%. (2) The sex, body mass index, fracture to surgery time, presence of diabetes, hypertension, and femoral head avascular necrosis had no obvious correlation (P > 0.05). The patient’s age, preoperative traction, surgical plan, reset quality, full load time, and internal fixation removal time were all related factors for the femoral head avascular necrosis after screw internal fixation for femoral neck fracture (P < 0.05). (3) The age greater than 55 years old, preoperative traction, hollow screw internal fixation, Garden III, type IV reset quality, and complete weight bearing within 3 months after surgery were risk factors for the femoral head avascular necrosis after screw internal fixation for femoral neck fracture (P < 0.05). (4) The risk factors of the femoral head avascular necrosis after screw internal fixation for femoral neck fracture of Pauwels type III are the age greater than 55 years old, preoperative traction, hollow screw internal fixation, Garden III, type IV reset quality, and complete weight bearing within 3 months after surgery. Effective control of these factors can reduce and prevent postoperative avascular necrosis of the femoral head.

Key words: femoral neck fracture, Pauwels III, screw internal fixation, avascular necrosis of femoral head, risk factors, age, preoperative traction, weight-bearing

CLC Number:

R459.9|R318|R687.3+2

Chen Haihong, Zhang Qingwen, Gao Dawei, Lin Zhijiong, Deng Bin, Zhang Huiliang. Influential factors on femoral head avascular necrosis after screw internal fixation for femoral neck fracture of Pauwels type III[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(36): 5782-5787.

Figures/Tables 4

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