Park Jung-Wee, Cha Yong-Han, Kim Jin-Woo, Kim Hong-Seok, Nho Jae-Hwi, Jang Byung-Woong, Kim Jung-Taek, Kim Jin-Kak, Kim Tae-Young, Kim Ki-Choul, Lee Young-Kyun
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Orthopaedic Surgery, Daejeon Eulji University Medical Center, Daejeon, South Korea.
J Orthop Trauma. 2025 Feb 1;39(2):63-67. doi: 10.1097/BOT.0000000000002926.
The purposes of this study were to investigate the frequency of screwdriver stripping in the head of the locking screw that attaches to the side plate to the femur shaft among the patients who underwent implant removal after femoral neck system (FNS) for femoral neck fracture, to determine the risk factors for locking head screw stripping in FNS treatment of femoral neck fracture, and to suggest a surgical tip that removes FNS, which is difficult to remove due to screw stripping.
Retrospective cohort study.
Eight Urban tertiary referral academic hospitals.
Included were patients with Orthopedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen 31-B1, 31-B2, and 31-B3 femoral neck fractures who underwent surgical fixation with FNS from November 2019 to February 2023.
The frequency of locking head screw stripping of FNS during the implant removal was evaluated.
Among the 47 patients (18 (38%) men and 29 (62%) women) who met the inclusion criteria with an average age of 59.2 years (range, 28-94 years), 13 (27.7%) experienced screwdriver stripping in the head of the distal locking screw during FNS removal surgery. A higher body mass index showed a borderline significant association with the stripping in the adjusted model (odds ratio = 1.233; 95% confidence interval: 0.988-1.539; P = 0.064). No other variables showed significant association with the stripped locking head screw ( P > 0.05).
Stripping of the screwdriver within the head of the distal locking screw occurred in over one-quarter of cases. While a higher body mass index demonstrated a borderline significant association, none of the other variables examined showed a statistically significant relationship with the stripped locking head screw.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
本研究旨在调查股骨颈骨折患者接受股骨颈系统（FNS）治疗后进行植入物取出时，连接侧板与股骨干的锁定螺钉头部螺丝刀滑丝的频率，确定FNS治疗股骨颈骨折时锁定头螺钉滑丝的危险因素，并提出一种用于取出因螺钉滑丝而难以取出的FNS的手术技巧。
回顾性队列研究。
八家城市三级转诊学术医院。
纳入2019年11月至2023年2月期间因骨科创伤协会/骨科学术问题 Arbeitsgemeinschaft für Osteosynthesefragen 31 - B1、31 - B2和31 - B3型股骨颈骨折接受FNS手术固定的患者。
评估植入物取出过程中FNS锁定头螺钉滑丝的频率。
在符合纳入标准的47例患者（18例（38%）男性和29例（62%）女性）中，平均年龄59.2岁（范围28 - 94岁），13例（27.7%）在FNS取出手术期间远端锁定螺钉头部出现螺丝刀滑丝。在调整模型中，较高的体重指数与滑丝呈临界显著关联（比值比 = 1.233；95%置信区间：0.988 - 1.539；P = 0.064）。没有其他变量与滑丝的锁定头螺钉显示出显著关联（P > 0.05）。
超过四分之一的病例中出现远端锁定螺钉头部螺丝刀滑丝。虽然较高的体重指数显示出临界显著关联，但所检查的其他变量均未显示与滑丝的锁定头螺钉有统计学显著关系。
预后III级。有关证据级别的完整描述，请参阅作者指南。
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