Analysis Of Factors Related To Femoral Head Necrosis After Closed Reduction With Cannulated Screws For Femoral Neck Fracture

Purpose:To investigate the effect of gender,age,fracture type,post-injury surgery time,whether patients were combined with medical diseases,intraoperative blood loss,intraoperative reduction quality after closed reduction with cannulated screws.At the same time,the relationship between the third stage syndrome differentiation treatment of traditional Chinese medicine and femoral head necrosis was studied to provide some guidance for clinical practice.Methods:To analyze the patients who underwent closed reduction with cannulated screws for femoral neck fracture in our hospital from March 2012 to December 2017,By querying the surgical records In the surgical section,as well as medical record retrieval,outpatient follow-up and telephone,WeChat return visit,etc.Relevant case data were collected and postoperative recovery status of the patient(whether femoral head necrosis occurred)was recorded.A total of 147 patients(147 hips)were eventually included.Single analysis was used to stduy the influence of 8 factors at first,including gender,age,post-injury surgery time,intraoperative blood loss,fracture type,whether patients were combined with medical diseases,reduction quality on femoral head necrosis.Factors with statistical significance were sclected for Multivariate Logistic analysis.secondly,in the necrotic group and non-necrotic group,patients with consistent baseline of all influencing factors were screened.according to whether the treatment was based on phase three syndrome differentiation of traditional Chinese medicine,chi-square test and analysis were carried out to find out the relationship between phase three syndrome differentiation and femoral head necrosis.Results:The mean follow-up period was 34 months(12~69 months),20 cases had necrosis,and the necrosis rate was 13.61%,Single factor analysis results showed that age(x~2=13.772,p=0.0001),fracture type(x~2=6.579,p=0.010),Surgery time after injury(x~2=4.152,p=0.042)and reduction quality(x~2=30.864,p=0.000)are the influencing factors of femoral head necrosis;And gender(x~2=1.953,p=0.162),,intraoperative blood loss(x~2=0.015,p=0.903)had no obvious significant effect on femoral head necrosis.The results of multi-factor analysis showed that reduction quality(P=0.029)and operation time after injury(P=0.026)were important risk factors for bone necrosis.The third stage of TCM syndrome differentiation is helpful to reduce the incidence of femoral head necrosis and improve the quality of life of patients.Conclusions:1.Single factor analysis showed that age,fracture type,surgery time after injury,reduction quality are the risk factors of femoral head necrosis.2.Under the influence of multiple factors,the quality of fracture reduction and postoperative operation time are important factors affecting femoral head necrosis.3.The third stage syndrome differentiation is helpful to reduce the occurrence of femoral head necrosis.