Incidence rate and risk factors analysis of the avascular necrosis of femoral head after femoral neck fracture

ObjectiveTo explore the incidence rate and risk factors of the avascular necrosis of femoral head after femoral neck fracture.

MethodsThe clinical data of 272 femoral neck fracture patients treated with closed reduction and compression screw fixation were retrospectively analyzed.The patients were divided into the necrosis group(37 cases) and healing group(235 cases) according to whether having femoral head necrosis or not.The time from injury to operation, fracture side, operation time, preoperative traction, preoperative complications, preoperative Garden classification, Garden index after reduction, Harris hip score, blood lipid level and postoperative activity time were compared between two groups.The logistic regression analysis was used to investigate the risk factors of postoperative femoral head necrosis.

ResultsThe differences of the preoperative Garden classification, Garden index after reduction, Harris hip score, total cholesterol and triglyceride between two groups were statistically significant(P < 0.05 to P < 0.01).The high Garden index before surgery, high Garden index after reduction, high total cholesterol and triglyceride were the independent risk factors of avascular necrosis of femoral head(P < 0.05).

ConclusionsThe risk factors of femoral head necrosis after femoral neck fracture include the high levels of total cholesterol and triglyceride, high preoperative Garden classification and poor quality of fracture reduction.In order to reduce the incidence rate of the femoral head necrosis, the intraoperative anatomic reduction should be achieved as far as possible, and the perioperative lipid should be actively controlled.