Clinical efficacy and failure analysis of biplane double-supported screw fixation in treatment of femoral neck fracture

LIU Chang-tie; MAO Yu-lin; LIU Jun-lin; WEI Shi-qiang

doi:10.11659/jjssx.08E024106

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Clinical efficacy and failure analysis of biplane double-supported screw fixation in treatment of femoral neck fracture

Clinical Research | 更新时间：2025-10-24

- Clinical efficacy and failure analysis of biplane double-supported screw fixation in treatment of femoral neck fracture
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 10, Pages: 876-880(2025)
- 作者机构：
  
  江西省赣州市人民医院创伤急救中心，江西赣州 341000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E024106
  CLC： R683.42
- Received：27 August 2024，
  
  Published：25 October 2025
- 稿件说明：
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刘长铁,毛玉琳,刘俊林等.双平面双支撑螺钉固定技术治疗股骨颈骨折的临床疗效及失败原因分析[J].局解手术学杂志,2025,34(10):876-880.

LIU Chang-tie,MAO Yu-lin,LIU Jun-lin,et al.Clinical efficacy and failure analysis of biplane double-supported screw fixation in treatment of femoral neck fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):876-880.
刘长铁,毛玉琳,刘俊林等.双平面双支撑螺钉固定技术治疗股骨颈骨折的临床疗效及失败原因分析[J].局解手术学杂志,2025,34(10):876-880. DOI： 10.11659/jjssx.08E024106.

LIU Chang-tie,MAO Yu-lin,LIU Jun-lin,et al.Clinical efficacy and failure analysis of biplane double-supported screw fixation in treatment of femoral neck fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):876-880. DOI： 10.11659/jjssx.08E024106.

摘要

目的

探究双平面双支撑螺钉固定技术（BDSF）治疗股骨颈骨折（FNF）的临床疗效及手术失败的影响因素。

方法

选择2022年11月至2024年5月于本院住院治疗的360例FNF患者为研究对象。根据随机数字表法，将患者分为观察组[多学科协作诊疗（MDT）与绿色通道模式下应用BDSF治疗

]

和对照组[MDT与绿色通道模式下应用空心螺钉（CCS）固定治疗

]

，每组180例；根据观察组手术治疗失败或固定失败情况，进一步将患者分为手术失败组（

=50）和手术有效组（

=130）。通过多因素

Logistic

回归分析危险因素。模型的建立与拟合均采用

Logistic

回归分析。模型的区分度、预测精度、临床价值分别采用受试者工作特征（

ROC

）曲线、校准曲线、临床决策曲线（

DCA

）进行评估。

结果

与对照组相比，观察组患者的手术时间、住院时间均更短（

0.05），术中出血量、术中透视次数均更少（

0.05），股骨头缺血性坏死、固定失败的患者比例更低（

0.05），术后24个月髋关节Harris评分更高（

0.05）。Garden分型、骨折线部位、复位质量、术前牵引均为手术失败的独立影响因素（

0.05）。

ROC

曲线分析结果显示，模型预测手术失败风险的曲线下面积（

AUC

）为0.867（95%

：0.751~0.946）。校准曲线分析结果显示，模型预测概率近似等于实际概率，Brier值为0.095。

DCA

分析结果显示，模型阈概率为0.1~0.9净收益较高。

结论

BDSF治疗FNF手术效果良好，可缩短手术时间和住院时间，减少术中透视次数和出血量，更有利于髋关节功能恢复。Garden分型、骨折线部位、复位质量、术前牵引均为手术失败的独立影响因素。

Abstract

Objective

To explore the clinical efficacy of biplane double-supported screw fixation （BDSF） in the treatment of femoral neck fracture （FNF） and the influencing factors of surgical failure.

Methods

A total of 360 patients with FNF hospitalized in our hospital from November 2022 to May 2024 were selected as the research objects. According to the random number table method，the patients were divided into the observation group ［application of BDSF under the multi-disciplinary treatment （MDT） and green channel mode］ and the control group ［application of cannulated compression screw （CCS） fixation under the MDT and green channel mode］，with 180 cases in eac

h group； According to the failure of surgical treatment or fixation in the observation group，the patients were further divided into the surgical failure group （

=50） and effective surgery group （

=130）.The risk factors were analyzed by multivariate

Logistic

regression.The establishment and fitting of the model were analyzed by

Logistic

regression. The discrimination，prediction accuracy and clinical value of the model were evaluated by

receiver operating characteristic

（

ROC

） curve，calibration curve and

decision curve analysis

（

DCA

） curve，respectively.

Results

Compared with the control group，the observation group had shorter operation time and hospitalization time （

0.05），less intraoperative blood loss and fewer intraoperative fluoroscopy times （

0.05），lower proportion of patients with avascular necrosis of femoral head and fixation failure （

0.05），and higher Harris hip score 24 months after operation （

0.05）. Garden classification，fracture line location，reduction quality and preoperative traction were the independent influencing factors of surgical failure （

0.05）. The

ROC

curve analysis showed that the

area under the curve

（

AUC

） of the model to predict the risk of surgical failure was 0.867 （95%

： 0.751 to 0.946）. The calibration curve analysis results showed that the predicted probability of the model was approximately equal to the actual probability，with a Brier value of 0.095.

DCA

analysis results showed that the threshold probability of the model was 0.1 to 0.9，indicating a high net profit.

Conclusion

BDSF has a good effect in FNF surgery，which can shorten the operation time and hospitalization time，reduce the number of intraoperative fluoroscopy and bleeding，which is more conducive to hip joint function recovery. Garden classification，fracture line location，reduction quality，and preoperative traction are all the independent influencing factors for surgical failure.

关键词

Keywords

references

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