Analysis of the Relationship and Predictive Value between the TFD Value and Postoperative Fixation Failure in Patients Undergoing TGN Internal Fixation for Intertrochanteric Femoral Fracture
LI Wujian, HE Shaobo, REN Cong, et al
3201 Hospital Affiliated to Xi'an Jiaotong University, Shaanxi Hanzhong 723000, China
Abstract：Objective: To investigate the relationship between distance between tail femur distance (TFD) value and postoperative fixation failure in patients with femoral intertrochanteric fractures treated with the third-generation Gamma nail (TGN) internal fixation. Methods: The case data of 160 patients with femoral intertrochanteric fractures treated with TGN internal fixation in the hospital from January 2022 to August 2024 were retrospectively analyzed. According to the postoperative fracture healing status, the patients were divided into normal healing group (n=128) and fixation failure group (n=32). The differences in general data and TFD value were recorded and compared between groups. Multivariate logistic regression analysis was used to analyze the independent influencing factors of postoperative fixation failure. Receiver operating characteristic curve (ROC) was drawn to analyze the value of the above statistically significant indicators on predicting postoperative fixation failure. Results: At 6 months after surgery, the proportions of patients with normal fracture healing, patients with postoperative lag screw migration and patients with postoperative lag screw cutting-out were 80.00% (128/160), 12.50% (20/160) and 7.50% (12/160), respectively. Comparison of general data found that the bone mineral density T value in normal healing group was higher than that in fixation failure group, and the TFD value was shorter than that in fixation failure group (P<0.05). Multivariate Logistic regression analysis showed that bone mineral density T value and TFD value were independent influencing factors of postoperative fixation failure (P<0.05). ROC curve analysis showed that the areas under the curves (AUCs) of bone mineral density T value and TFD value in predicting postoperative fixation failure were 0.818 and 0.906, respectively. Conclusion: The fixation failure after TGN internal fixation of femoral intertrochanteric fractures is closely related to bone mineral density T value and TFD value, and has certain predictive value on postoperative fixation failure.
李伍建, 何少波, 任聪, 张根生, 郑琎喆, 刘杨洋, 刘继超. 股骨粗隆间骨折TGN内固定术治疗的患者TFD值与术后固定失败的关系及预测价值分析[J]. 河北医学, 2025, 31(12): 2089-2093.
LI Wujian, HE Shaobo, REN Cong, et al. Analysis of the Relationship and Predictive Value between the TFD Value and Postoperative Fixation Failure in Patients Undergoing TGN Internal Fixation for Intertrochanteric Femoral Fracture. HeBei Med, 2025, 31(12): 2089-2093.
[1] 张俊,厉国定,王健.骨折端加压螺钉结合锁定钢板固定老年股骨远段简单骨折的生物力学分析[J].临床骨科杂志,2022,25(6):894-899. [2] 王澍寰.骨与关节损伤[M].第5版.北京:人民卫生出版社,2020.432-438. [3] 侯宇,姚琦,张亘瑷,等.第3代Gamma钉拉力螺钉钉尾距股骨外侧皮质距离与术后拉力螺钉移位或切出关系研究[J].中国修复重建外科杂志,2018,32(1):40-44. [4] Wang YXJ,Blake GM,Xiao BH,et al.East Asians' T-scores for the diagnosis of osteoporosis should be calculated using ethnicity- and gender-specific BMD reference ranges: justifications[J].Skeletal Radiol,2024,53(3):409-417. [5] Li QD,Yang JS,He BR,et al.Risk factors for proximal junctional kyphosis after posterior long-segment internal fixation for chronic symptomatic osteoporotic thoracolumbar fractures with kyphosis[J].BMC Surg,2022,22(1):189. [6] Turgut A,Filibeli M,Kumbaraci M,et al.Reliability of evaluation of the surgeon-dependent factors affecting mechanical failure after intertrochanteric femur fracture treatment[J].Acta Chir Orthop Traumatol Cech,2022,89(1):75-80. [7] Lee H,Kim SA,Jo S,et al.Biomechanical analysis analyzing association between bone mineral density and lag screw migration[J].Sci Rep,2023,13(1):747. [8] 陈锋,许勇,贺弘,等.PKP治疗不同骨密度T值骨质疏松症患者的临床疗效及预后[J].医学研究杂志,2024,53(4):101-106.
2025, Vol. 31 
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