中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (3): 620-625.doi: 10.12307/2025.931

• 骨科植入物Orthopedic implants • 上一篇    下一篇

股骨颈骨折空心钉内固定后颈短缩的单变量及多变量回归分析

徐新宝1,陈飞扬2,陈银兵1,章飞翔1,吕书军1,崔海东1,陈志刚1   

  1. 1海安市人民医院,南通大学附属海安医院,江苏省海安市  226600;2扬州大学医学院,江苏省扬州市  225009
  • 收稿日期:2024-09-13 接受日期:2024-11-30 出版日期:2026-01-28 发布日期:2025-07-03
  • 通讯作者: 陈志刚,博士,主任医师,海安市人民医院,南通大学附属海安医院骨科,江苏省海安市 226600
  • 作者简介:徐新宝,男,1989年生,江苏省盐城市人,汉族,2016年南通大学医学院毕业,硕士,主治医师,主要从事关节外科方面的研究。
  • 基金资助:
    南通市科技计划项目(GJZ17075),项目负责人:陈志刚

Univariate and multivariate regression analysis of femoral neck shortening after cannulated screw fixation in femoral neck fractures

Xu Xinbao1, Chen Feiyang2, Chen Yinbing1, Zhang Feixiang1, Lyu Shujun1, Cui Haidong1, Chen Zhigang1   

  1. 1Hai’an People’s Hospital, Affiliated Hai’an Hospital of Nantong University, Hai’an 226600, Jiangsu Province, China; 2Medical College of Yangzhou University, Yangzhou 225009, Jiangsu Province, China
  • Received:2024-09-13 Accepted:2024-11-30 Online:2026-01-28 Published:2025-07-03
  • Contact: Chen Zhigang, MD, Chief physician, Hai’an People’s Hospital, Affiliated Hai’an Hospital of Nantong University, Hai’an 226600, Jiangsu Province, China
  • About author:Xu Xinbao, MS, Attending physician, Hai’an People’s Hospital, Affiliated Hai’an Hospital of Nantong University, Hai’an 226600, Jiangsu Province, China
  • Supported by:
    Nantong Science and Technology Project, No. GJZ17075 (to CZG)

摘要:

文题释义:

股骨颈骨折:为股骨头下至股骨基底部之间的骨质断裂,多数发生在中老年人,与骨质疏松导致的骨质量下降有关,当遭受轻微扭转暴力则可发生骨折。多数情况是在走路时滑倒时,身体发生扭转倒地,间接暴力传导导致股骨颈发生骨折。青少年发生股骨颈骨折较少,常需较大的暴力才会引起,且不稳定型更多见。
股骨颈短缩:股骨颈骨折空心螺钉内固定治疗后,部分患者术后股骨颈长度缩短,螺钉向外退出,造成患者术后髋关节功能障碍。

摘要
背景:随着社会老龄化趋势的发展,股骨颈骨折的发病率日益上升,目前临床上最常用的治疗方式是空心螺钉内固定,然而一些患者在术后出现股骨颈缩短,从而影响髋关节的功能。
目的:调查股骨颈骨折半螺纹空心螺钉内固定后股骨颈短缩的发生率,并分析其对髋关节功能的影响,同时探讨导致股骨颈短缩的因素。
方法:回顾性分析2016年1月至2021年1月在南通大学附属海安医院进行半螺纹空心螺钉内固定治疗的102例股骨颈骨折患者的病历资料,其中男36例,女66例;平均年龄(57.2±7.7)岁;骨折类型:Garden Ⅰ,Ⅱ型34例,Garden Ⅲ,Ⅳ型68例;平均骨密度T值为-2.8 SD。使用Harris评分系统评估髋关节功能;在整个随访期,患者通过X射线片观察股骨颈的缩短程度,并利用单变量及多变量回归分析来探讨股骨颈缩短的影响因素。
结果与结论:①102例股骨颈骨折患者中,30例出现了股骨颈缩短,比例为29.4%;其他72例患者则未见明显缩短,比例为70.6%;②缩短组患者的髋关节Harris评分显著低于非缩短组(P < 0.05);③股骨颈缩短的相关因素包括患者的年龄、性别、骨密度T值、术前Garden分型和术中骨折复位质量,这些因素不仅影响术后股骨颈的缩短,还直接关系到患者髋关节的功能表现;④股骨颈骨折术后颈部缩短与多种临床参数有关,尤其是患者的年龄、性别、骨密度、术前分型及手术中复位的准确性。



中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 股骨颈骨折, 空心螺钉, 内固定, 股骨颈短缩, 髋关节功能, 骨科植入物

Abstract: BACKGROUND: With the development of the aging trend of society, the incidence of femoral neck fractures is increasing. Currently, the preferred surgical treatment is cannulated screw internal fixation. However, post-surgical femoral neck shortening occurs in some cases, resulting in impaired hip functionality.
OBJECTIVE: To investigate the incidence of femoral neck shortening following the use of half-threaded cannulated screws for internal fixation in patients with femoral neck fractures, to analyze the effect on hip function, and to identify factors contributing to neck shortening.  
METHODS: A retrospective analysis was conducted on the medical records of 102 patients treated with half-threaded cannulated screws in an inverted triangle setup for femoral neck fractures at Affiliated Hai’an Hospital of Nantong University from January 2016 to January 2021. This group included 36 males and 66 females at the mean age of (57.2±7.7) years, with 34 cases of Garden type I and II fractures and 68 of Garden type III and IV fractures. The mean bone mineral density value T was -2.8 SD. The Harris score was used to evaluate the hip function. During the follow-up period, the occurrence of femoral neck shortening was determined using X-ray imagery, and the factors influencing this shortening were examined using both univariate and multivariate regression analyses.
RESULTS AND CONCLUSION: (1) Among the 102 patients with femoral neck fractures, 30 patients developed femoral neck shortening, accounting for 29.4%. 72 patients had no femoral neck shortening (70.6%). (2) The Harris score for patients experiencing neck shortening was significantly lower than that for patients without shortening (P < 0.05). (3) The study identified several factors associated with femoral neck shortening following the internal fixation of femoral neck fractures included age, gender, bone mineral density value T, preoperative Garden classification, and quality of reduction. These factors not only affect the shortening of the femoral neck after surgery, but are also directly related to the functional performance of the patient’s hip joint. (4) Femoral neck shortening after surgery for femoral neck fracture is associated with various clinical parameters, especially the patient’s age, gender, bone mineral density, preoperative classification, and accuracy of reduction during surgery.

Key words: femoral neck fracture, cannulated screw, internal fixation, femoral neck shortening, hip function, orthopedic implant

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