The Correlation Factors Analysis Of The Femoral Head Necrosis After Internal Fixation In Femoral Neck Fracture

Objective: To observe the accidence of the femoral head necrosis (FHN) afterinternal fixation in femoral neck fracture and analysis of the related factors.Methods:146cases of femoral neck fractures treated with internal fixation andeffective follow-up between Jan.2004and Dec.2008were reviewed retrospectively. Weanalyzed the factors including age, gender, Garden classification, the quality of fracturereduction, reduction methods, interval from injury to surgery, preoperative traction, time ofweight bearing, fixation removal.Results: Complete case records were documented in146patients who werefollowed up for an average of52months (9-84M).The incidence of the FHN occurred was14.4%(21/146).The average time to diagnosis of FHN was18months (9～56M). Patientsage (P=0.99), gender (P=0.287), interval from injury to surgery (P=0.36), time of weightbearing (P=0.86), reduction methods (P=0.987) were statistically not associated with theFHN. Garden classification (P=0.012), the quality of fracture reduction (P=0.008), fixationremoval (P=0.02), preoperative traction (P=0.003) were significantly associated. In themultivariate logistic regression analysis, we found that Garden classification (P=0.011), thequality of fracture reduction (P=0.026), preoperative traction (P=0.000) were significantlyassociated with the FHN. However, implant removal was an insignificant influence onFHN development (P=0.498).Conclusion: Garden classification, the quality of fracture reduction, preoperativetraction produced a significant impact on the development of the FHN.