The Risk Factors Analysis Of Fracture Nonunion And Avascular Necrosis Of The Femoral Head After Internal Fixation With Cannulated Screws In Femoral Neck Fractures

ObjectiveOn the purpose of optimal treatment, the accidence of the fracture nonunion and the avascular necrosis of the femoral head with cannulated screws in femoral neck fractures femoral were retrospectively analyzed, combined with imaging datas.Methods71 patients with femoral neck fracture, who were all treated with cannu-lated screws in the first affiliated hospital of guangzhou university of TCM, According to the standard, we rejected the patients whose information were incompleted. Based on the X-ray check, MRI results and the diagnosis and treatment measures, many points were observed, range from sexuality, fracture displacement, whether open reduction or not, reduction index, preoperative traction or not, BMI to the sistution of fracture healing and femoral head. All the factors were analyzed by SpSS22.0 statistic system to evaluate the accidence of the fracture nonunion and the avascular necrosis of the femoral head.20 patients were selected from those 71 cases.which had completed imaging datas, all of them were peformed MRI after internal fixation in femoral neck fractures, 1-4momths,5-8momths,9-12momths and above 13months, and grouped by whether or not.Both of the group number is 10.We had a dynamic observation on the joint effusion during different period, inordered to find the connection bewteen joint effusion and the necrosis of femoral head.ResultsA folowed-up began on patients was for an average of 35 months (9-65m) from Jan 2010 to Jun 2015. The case of fracture nonunion was 9, whose morbidity was12.7%, while, the incidence of necrosis of the femoral head occurred was 31.0%(22/71). All the factors were analyzed by SpSS22.0 statistic system. It shows that the group of the fracture nonunion, patients gender (P=0.136), age(P=0.012), fracture displacement (P=0.004), open reduction (P.019), eduction index (P=0.000), preoperative traction (P=0.004) and BMI(P=0.199) were statistically;the group of necrosis of the femoral head, patients gender (P=0.406), age(P=0.168), fracture displacement (P=0.015),open reduction (P=0.032), reduction index (P=0.020), preoperative traction (P=0.094), BMI (P=0.025) and joint effusion (P=0.000)were statistically.ConclusionThe common mechanisms between fracture nonunion and necrosis of the femoral head (FNH) after internal fixation with cannulated screws in femoral neck fractures were fracture displacement and the reduction index.The the factor of age was associated with the fracture nonunion. BMI was an incidence that affecting the FHN.The amount of joint effusion was an incidence that affecting the FHN.