Analysis Of Factors Of Femoral Head Necrosis After Closed Reduction Internal Fixation Of Femoral Neck Fracture

Objective: A retrospective analysis was performed to investigate whether there is a difference in the incidence of femoral head necrosis after closed reduction internal fixation of femoral neck fractures with different anatomical subtypes,and the influence of other factors on femoral head necrosis and risk prediction.Methods: The gender,age,fracture side,anatomical typing,Garden typing,internal fixation method(three hollow nails,power hip screws,femoral neck system),and quality of reduction were collected from 309 patients treated with closed reduction internal fixation for femoral neck fractures admitted to the Fourth Clinical Medical College of Xinjiang Medical University from March 2009 to February 2022,and divided into two groups based on whether the femoral head was necrotic after surgery.statistical analysis.The above factors were first analyzed univariately,and then multivariate logistic regression was applied for statistical analysis of the above statistically significant factors.Results: By following up 309 patients with femoral neck fractures who underwent closed reduction internal fixation included in this study,a total of77 patients developed postoperative femoral head necrosis,and the results of univariate analysis showed that: gender(P=0.532)and fracture side(P=0.373),which were not statistically significant;Age(P=0.017),Garden’s staging(P<0.001),anatomical staging(P<0.001),quality of repositioning(P<0.001),and mode of internal fixation(P=0.043),which were statistically significant and independent risk factors;Further regression analysis applying multiple logistic regression for statistically significant factors yielded age(P=0.004),quality of repositioning(P<0.001),anatomic staging(P<0.001),Garden staging(P=0.001),and mode of internal fixation(P=0.006)were statistically significant.Conclusion: Closed reduction internal fixation should be preferred for young femoral neck fractures.Patients with femoral neck fractures between 60 and 70 years of age decide whether internal fixation treatment or joint replacement should be performed according to the degree of fracture displacement,the quality of intraoperative repositioning and the degree of stability,and the rate of secondary surgery for closed reduction internal fixation is high in elderly patients with femoral neck fractures.