The incidence and prognosis of avascular necrosis of femoral head after operation of femoral neck fractures
- VernacularTitle:股骨颈骨折术后股骨头缺血性坏死的发生及转归
- Author:
Jie WEI
;
Li ZHOU
;
Manyi WANG
- Publication Type:Journal Article
- Keywords:
Femoral neck fractures;
Femur head necrosis;
Retrospective studies
- From:
Chinese Journal of Orthopaedics
2001;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the incidence and prognosis of avascular necrosis of femoral head after internal fixation of femoral neck fractures. Methods 137 cases of femoral neck fracture treated with internal fixation between January 1993 and December 1999 were evaluated retrospectively. The average age was 49.1 years ( range, 17-77 years ). According to Garden classification, 4 cases were of stageⅠ; 23 of Ⅱ; 71 of Ⅲ; 38 of Ⅳ. One case could not be classified. The mean duration of follow-up was 49.1 months with a range from 14 to 95 months. Results Until January 2001, avascular necrosis of the femoral head was found in 51 cases (37.2%), among them late collapse occurred in 33 cases (24.1%). Avascular changes of the femoral head were found within 5 years after injury in most of the cases. The common clinical findings in the patients with avascular necrosis were: limited motion, limp and pain. Even if segmental collapse developed, about 30% patients had no complaint of pain, but the average Harris score was obviously lower than that of the patients without collapse. Statistical results showed that the related factors influencing the prognosis of avascular necrosis and late collapse were: degree of displacement of the fracture and quality of reduction. The location and extent of necrotic area were markably related to the development of late collapse. Conclusion Follow-up after operation of femoral neck fracture is important, it should be taken at least for 5 years. Close and thoughtful examination is recommended, especially in the 2nd to 3rd year after injury.