非移位型股骨颈骨折发生股骨头后倾角的研究OACSTPCDMEDLINE

Objective To investigate the occurrence of posterior femoral head tilt after clinical non-displaced femoral neck fracture,and to provide a reference basis for clinical surgery and improvement of disease prognosis.Methods Total of 165 pa-tients with non-displaced femoral neck fractures of Garden type Ⅰ and Ⅱ from January 2018 to June 2022 were selected as study subjects including 48 males and 117 females,with an average age of(71.5±8.5)years old ranging from 53 to 89,involving 97 cases of type Ⅰ and 68 of type Ⅱ.On the patient's preoperative sagittal or axial CT film of the hip,the angle formed by the ra-dius line of the femoral head and the midline of the femoral neck was used as the posterior tilt angle of the femoral head(α),and the posterior tilt femoral head angle was measured using the method proposed by Palm.The measured data were divided into 6 groups:α＜0°,0°＜α＜5°,5°≤α＜10°,10°≤α＜15°,15°≤α＜20°,α≥20°,and the incidence of different ranges of poste-rior tilt angle was compared.The sex composition ratio of 165 patients were analyzed and compared,and the age of 65 was used as the cut-off point to compare the incidence of fractures between genders.Patients were divided into the posterior tilt＜20° group for 135 cases and the posterior tilt ≥20°group for 30 cases according to the preoperative posterior tilt angle,the differ-ences between two groups in terms of gender and age were analyzed.Results Among 165 patients with non-displaced femoral neck fractures,143 cases with poaterior tilt of the femoral head occurred with an incidence of 86.7％.Posterior tilt 0°＜α＜5° ac-counted for 36 cases with an incidence of 21.8％;5°≤α＜10° accounted for 40 cases with an incidence of 24.2％;10°≤α＜15° accounted for 27 cases with an incidence of 16.4％;15°≤α＜20° accounted for 10 cases with an incidence of 6.1％;posterior tilt angle α≥20° accounted for 30 cases,the incidence was 18.2％,of which the maximum posterior tilt angle was 42.7°.Statis-tical analysis showed that the percentage of fractures in the 165 patients selected for this study was significantly higher in fe-male than in male,and that the female group was more likely to have fractures before the age of 65 years compared to the male group.However,gender,age and fracture subtypes(Garden Ⅰ,Ⅱ)were not influential factors for femoral neck fractures with a preoperative posterior femoral head tilt angle＞20°(P＞0.05).Conclusion The incidence of femoral head posterior tile in non-displaced femoral neck fractures is relatively high,in which severe posterior tile occurs,and the femoral head posterior tile an-gle ≥20° can reach 18.2％.In patients with closed reduction internal fixation,the fracture end needs to be repositioned as much as possible to reduce the risk of postoperative avascular necrosis of the femoral head.In order to prevent femoral neck frac-tures,special attention should be paid to anti-osteoporosis treatment for female.Preoperative assessment of posterior tilt is criti-cal for patients of different ages,genders and fracture subtypes(Garden Ⅰ,Ⅱ).