摘要
股骨颈骨折是临床上常见的骨折类型，随着社会老龄化和高速能量损伤患者的增多，股骨颈骨折近年来发病率逐渐上升。其中老年人无移位骨折以及青壮年移位骨折，空心螺钉内固定是当前手术治疗的主流。常规的倒等腰三角形构型中，空心螺钉穿出股骨颈的几率很大，穿出的股骨颈不仅可能造成股骨头缺血性坏死，而且可能造成骨折延迟愈合或不愈合，大大增加了空心螺钉治疗股骨颈骨折的术后并发症，因此如何避免上方螺钉穿出股骨颈（IN-OUT-IN）的研究尤为重要。本文将对避免空心螺钉穿出股骨颈（IN-OUT-IN）的研究进展做一综述。
关键词： 股骨颈骨折；空心螺钉穿出；内固定失效;股骨头坏死
Abstract
Femoral neck fracture is a common fracture type in clinical practice. With the aging society and the increasing number of patients with high-speed energy injury, the incidence of femoral neck fracture has gradually increased in recent years. Among the displaced fractures in the elderly and young adults, hollow screw internal fixation is the mainstream of current surgical treatment. In the conventional isosceles triangle configuration, there is a high probability of hollow screws penetrating the femoral neck, which may not only cause avascular necrosis of the femoral head, but also delay or non-union of the fracture. It has greatly increased the postoperative complications of femoral neck fracture treated with hollow screw, so it is particularly important to study how to avoid the insertion of the upper screw into the femoral neck (IN-OUT-IN). This article reviews the research progress in avoiding hollow-core screw penetration of femoral neck (IN-OUT-IN).
Key words： Femoral neck fracture; Hollow screw out; Internal fixation failure; Femoral head necrosis
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