Liu Qi, Zhang Kaijun, Zhao Bin, Du Haoyuan, Zhang Teng, Han Wei, Wang Junqiang
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
National Center of Orthopaedics, Beijing, China.
Orthop Surg. 2025 Sep;17(9):2653-2661. doi: 10.1111/os.70147. Epub 2025 Aug 13.
Given the critical biomechanical role of the calcar femorale in load transmission and fracture stability, understanding its relationship with postoperative complications is essential for optimizing surgical outcomes. Therefore, this study aimed to explore the relationship between calcar femorale injury and postoperative complications of femoral neck fracture in young and middle-aged patients.
A retrospective analysis was conducted on 350 femoral neck fracture patients (aged 18-65 years) treated with closed reduction and three cannulated screws fixation at a single institution from 2015 to 2020. Evaluate the clinical and imaging information of patients such as sex, age, body mass index, Garden classification, calcar femorale injury situation, computed tomography Hounsfield units (CT HUs), comorbidities (e.g., diabetes, hypertension etc.) and complications (femoral neck shortening, nonunion, and femoral head necrosis). CT-based 3D reconstruction was used to analyze calcar femorale morphology. Statistical analyses included univariate and multivariate logistic regression to identify independent risk factors.
A total of 284 patients were included for analysis according to the inclusion and exclusion criteria. The results showed that Garden classification with displaced type (p < 0.001, OR = 4.615, 95% CI: 2.479-8.593), calcar femorale injury (p = 0.026, OR = 1.990, 95% CI: 1.087-3.645) and lower CT HUs (p = 0.002, OR = 0.989, 95% CI: 0.982-0.996) were independent risk factors for femoral neck shortening. Whether the patient has diabetes (p = 0.005, OR = 10.069, 95% CI: 2.043-49.628) was an independent risk factor for femoral neck nonunion. BMI (p = 0.030, OR = 1.154, 95% CI: 1.014-1.313) and Garden classification with displaced type (p < 0.001, OR = 10.000, 95% CI: 2.950-33.903) were independent risk factors for femoral head necrosis.
This study found that older patients with displaced type femoral neck fractures with calcar femorale injury are more likely to experience femoral neck shortening. Clinicians should pay close attention to the above risk factors to reduce the incidence of postoperative complications in young and middle-aged patients with femoral neck fractures.
鉴于股骨距在负荷传递和骨折稳定性方面的关键生物力学作用，了解其与术后并发症的关系对于优化手术效果至关重要。因此，本研究旨在探讨中青年股骨颈骨折患者股骨距损伤与术后并发症之间的关系。
对2015年至2020年在单一机构接受闭合复位和三枚空心螺钉固定治疗的350例股骨颈骨折患者（年龄18 - 65岁）进行回顾性分析。评估患者的临床和影像学信息，如性别、年龄、体重指数、Garden分型、股骨距损伤情况、计算机断层扫描亨氏单位（CT HU）、合并症（如糖尿病、高血压等）和并发症（股骨颈缩短、骨不连和股骨头坏死）。采用基于CT的三维重建分析股骨距形态。统计分析包括单因素和多因素逻辑回归，以确定独立危险因素。
根据纳入和排除标准，共纳入284例患者进行分析。结果显示，移位型Garden分型（p < 0.001，OR = 4.615，95%CI：2.479 - 8.593）、股骨距损伤（p = 0.026，OR = 1.990，95%CI：1.087 - 3.645）和较低的CT HU（p = 0.002，OR = 0.989，95%CI：0.982 - 0.996）是股骨颈缩短的独立危险因素。患者是否患有糖尿病（p = 0.005，OR = 10.069，95%CI：2.043 - 49.
