{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:07:36Z","timestamp":1788793656128,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005089","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["L234009"],"award-info":[{"award-number":["L234009"]}],"id":[{"id":"10.13039\/501100005089","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>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\u2010aged patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on 350 femoral neck fracture patients (aged 18\u201365\u2009years) 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\u2010based 3D reconstruction was used to analyze calcar femorale morphology. Statistical analyses included univariate and multivariate logistic regression to identify independent risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20094.615, 95% CI: 2.479\u20138.593), calcar femorale injury (<jats:italic>p<\/jats:italic>\u2009=\u20090.026, OR\u2009=\u20091.990, 95% CI: 1.087\u20133.645) and lower CT HUs (<jats:italic>p<\/jats:italic>\u2009=\u20090.002, OR\u2009=\u20090.989, 95% CI: 0.982\u20130.996) were independent risk factors for femoral neck shortening. Whether the patient has diabetes (<jats:italic>p<\/jats:italic>\u2009=\u20090.005, OR\u2009=\u200910.069, 95% CI: 2.043\u201349.628) was an independent risk factor for femoral neck nonunion. BMI (<jats:italic>p<\/jats:italic>\u2009=\u20090.030, OR\u2009=\u20091.154, 95% CI: 1.014\u20131.313) and Garden classification with displaced type (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u200910.000, 95% CI: 2.950\u201333.903) were independent risk factors for femoral head necrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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\u2010aged patients with femoral neck fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70147","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:16Z","timestamp":1755129616000},"page":"2653-2661","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Retrospective Study on the Relationship Between Calcar Femorale Injury and Postoperative Complications of Femoral Neck Fracture in Young and Middle\u2010Aged Patients Treated With Three Cannulated Screws"],"prefix":"10.1111","volume":"17","author":[{"given":"Qi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyuan","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9195-312X","authenticated-orcid":false,"given":"Teng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junqiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-07207-5"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453673208988851"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-57696-2"},{"issue":"1","key":"e_1_2_12_5_1","first-page":"163","article-title":"Femoral Neck Shortening After Fracture Fixation With Multiple Cancellous Screws: Incidence and Effect on Function","volume":"64","author":"Zlowodzki M.","year":"2008","journal-title":"Journal of Trauma"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.10.010"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000351"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-04114-8"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjtee.2017.07.003"},{"issue":"7","key":"e_1_2_12_10_1","first-page":"1035","article-title":"Delayed Internal Fixation of Fractures of the Neck of the Femur in Young Adults. A Prospective, Randomised Study Comparing Closed and Open Reduction","volume":"86","author":"Upadhyay A.","year":"2004","journal-title":"Journal of Bone and Joint Surgery. British Volume (London)"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191610050"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-021-00531-9"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2309499019848778"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1757-7861.2009.00053.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04324-3"},{"issue":"3","key":"e_1_2_12_16_1","first-page":"625","article-title":"The Calcar Femorale and the Femoral Neck","volume":"39","author":"Harty M.","year":"1957","journal-title":"Journal of Bone and Joint Surgery (American Volume)"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198010000-00018"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1530465"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2021.09.024"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.04.020"},{"issue":"1","key":"e_1_2_12_21_1","first-page":"3","article-title":"Idiopathic Bone Necrosis of the Femoral Head. Early Diagnosis and Treatment","volume":"67","author":"Ficat R. P.","year":"1985","journal-title":"Journal of Bone and Joint Surgery (British Volume)"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000038323"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-07325-0"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2025.112160"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001551"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-021-00484-5"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11101017"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15081014"},{"issue":"7","key":"e_1_2_12_29_1","article-title":"Complications and Outcomes of the Internal Fixation of Non\u2010Displaced Femoral Neck Fracture in Old Patients: A Two\u2010Year Follow\u2010Up","volume":"15","author":"Abdallatif A. G.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02580-6"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-022-00740-z"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mtbio.2023.100835"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.990457"},{"issue":"6","key":"e_1_2_12_34_1","first-page":"430","article-title":"Age is Not the Most Important Factor in the Prognosis of Femoral Neck Fracture: An Analysis of Long\u2010Term Clinical Follow\u2010Up","volume":"29","author":"Ju F. X.","year":"2023","journal-title":"Alternative Therapies in Health and Medicine"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-020-01724-4"},{"issue":"2","key":"e_1_2_12_36_1","first-page":"290","article-title":"Analysis of Risk Factors for Necrosis of Femoral Head After Internal Fixation Surgery in Young and Mid\u2010Aged Patients With Femoral Neck Fracture","volume":"52","author":"Liu B. C.","year":"2020","journal-title":"Beijing Da Xue Xue Bao Yi Xue Ban = Journal of Peking University Health Sciences"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-025-04264-x"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-08165-8"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T02:51:27Z","timestamp":1756867887000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":37,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/os.70147"],"URL":"https:\/\/doi.org\/10.1111\/os.70147","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]},"assertion":[{"value":"2024-12-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}