Abstract: Objective Investigating the relationship between smoking,overweight,and bibulosity with plasma PAI-1 and osteonecrosis of the femoral head after internal fixation by retrospective study,and providing reference for clinical treatment.Methods A total of 95 patients with femoral neck fracture treated with internal fixation from January 2021 to January 2022 were retrospectively studied.The data of smoking,overweight,alcohol abuse,preoperative and postoperative plasma PAI-1 levels were collected.The patients were divided into necrosis group and non-necrosis group according to the occurrence of femoral head necrosis at the last follow-up.Univariate analysis was performed on smoking,overweight,alcohol abuse,plasma PAI-1 level before and 2 days after operation,and the presence of smoking,overweight and bibulosity factors was analyzed.The association of smoking,overweight and bibulosity with plasma PAI-1 level was analyzed.Figure out the relationship between smoking,overweight,bibulosity and plasma PAI-1 and femoral head necrosis after internal fixation.Results Femoral head necrosis occurred in 22 of 95 patients.Age,gender,smoking,overweight and bibulosity were not independent risk factors for postoperative femoral head necrosis (P>0.05).The plasma PAI-1 level at 2 days after operation in necrosis group was (46.95±2.35) ng/ml,which was significantly higher than that in non-necrosis group [(41.94±4.73) ng/ml,P<0.05].The level of plasma PAI-1 at 2 days after operation was (48.29±1.78)ng/ml in patients with smoking,overweight and alcohol abuse at the same time,which was significantly higher than that in other patients [(42.40±4.60 ng/ml,P<0.05].In addition,when the smoking,overweight,and bibulosity were concurrent,it was a risk factor for femoral head necrosis (P<0.05).Conclusion  When the smoking,overweight,and bibulosity were concurrent,it can increases the risk of osteonecrosis of the femoral head after internal fixation,which may be related to the significant increase of plasma PAI-1 level,especially at 2 days after surgery.

Key words: femoral neck fractures, osteonecrosis of the femoral head, smoking, overweight, bibulosity, PAI-1