Yu Xiang, Li Yu-Zhi, Lu Hai-Jian, Ao Rong-Guang, Liu Bing-Li
Department of Orthopedics, Shanghai Seventh People's Hospital, Shanghai, China.
Front Surg. 2025 Apr 15;12:1589181. doi: 10.3389/fsurg.2025.1589181. eCollection 2025.
To explore the relevant factors affecting the efficacy of surgery for intertrochanteric fracture.
A retrospective case series study was conducted to analyze the clinical data of 212 patients with intertrochanteric fractures from January 2021 to December 2023. The patients, comprising 100 males and 112 females aged 65-98 years old (mean age 77.8 ± 10.5 years), were categorized based on fracture healing outcomes into a normal healing group (163 cases) and an abnormal healing group (49 cases, including 2 cases of non-union). Factors such as gender, age, injury side, fracture classification, thickness of femoral lateral wall, medial support, tip-apex distance and fixation position were recorded and analyzed through Logistic regression to identify the main factors influencing fracture healing.
Univariate analysis revealed statistically significant differences in AO classification, Evans-Jensen classification, medial support, tip-apex distance and main screw position between the two groups ( < 0.05). Logistic regression analysis indicated that AO type A1 (OR = 1.030), medial support (OR = 0.395), tip-apex distance ≤25 mm (OR = 0.266) and main screw located in the middle and lower part of the femoral head (OR = 0.986) were significantly related to fracture union ( < 0.05). The Oxford score of the normal fracture healing group (mean 42.6 ± 4.5 points) was higher than that of the abnormal healing group (mean 35.4 ± 3.2 points) ( < 0.05).
The stability of internal fixation is the most important factor affecting intertrochanteric fracture healing. The medial support, tip-apex distance ≤25 mm and the position of the screw are helpful for fracture healing and recovery of joint function.
探讨影响股骨转子间骨折手术疗效的相关因素。
采用回顾性病例系列研究，分析2021年1月至2023年12月期间212例股骨转子间骨折患者的临床资料。患者年龄65 - 98岁，男性100例，女性112例（平均年龄77.8±10.5岁），根据骨折愈合情况分为正常愈合组（163例）和异常愈合组（49例，包括2例骨不连）。记录性别、年龄、受伤侧、骨折分型、股骨外侧壁厚度、内侧支撑、尖顶距及固定位置等因素，并通过Logistic回归分析，以确定影响骨折愈合的主要因素。
单因素分析显示，两组在AO分型、Evans-Jensen分型、内侧支撑、尖顶距及主钉位置方面差异有统计学意义（<0.05）。Logistic回归分析表明，AO A1型（OR = 1.030）、内侧支撑（OR = 0.395）、尖顶距≤25 mm（OR = 0.266）及主钉位于股骨头中下部（OR = 0.986）与骨折愈合显著相关（<0.05）。正常骨折愈合组的牛津评分（平均42.6±4.5分）高于异常愈合组（平均35.4±3.2分）（<0.05）。
内固定稳定性是影响股骨转子间骨折愈合的最重要因素。内侧支撑、尖顶距≤25 mm及螺钉位置有助于骨折愈合及关节功能恢复。
