[Clinical observation of closed reduction and compression cannulated screw fixation for the treatment of femoral neck fracture in young and middle-aged patients]

Abstract

Objective: To investigate the clinical effect of internal fixation with closed reduction and hollow compression screws for the treatment of femoral neck fracture in young and middle-aged patients.

Methods: From June 2013 to December 2016, 33 young and middle-aged patients with femoral neck fractures were treated with hollow compression screws fixation including 17 males and 16 females with an average age of 38.5 years old ranged from 19 to 59 years old; 20 cases were on the left side and 13 cases on the right side;the time from injury to operation ranged from 2 to 5 days with an average of 3 days. According to Garden classification, 1 case were type I, 11 cases were type II, 18 cases were type III, 3 cases were type IV. During regular follow-up after operation, through the hip joint X-ray, the healing situation of bone and osteonecrosis were observed. The Harris score was used to evaluate the hip function of the final follow-up.

Results: The operation time was from 30 to 50 minutes, the blood loss during operation was 20 to 70 ml. All patients were followed up for 8 to 42 months with an average of 24 months. At the final follow-up, the Harris score of hip joint was excellent in 18 cases, good in 10 cases, fair in 2 cases and poor in 3 cases. Among them, the pain scores were 40.61±5.08, function scores were 38.94±6.78, malformation scores were 3.88±0.69, motion range scores were 3.70±0.64 and the total scores were 87.12±11.98. Thirty cases achieved bone healing, the healing time was 4 to 12 months with an average of 7.5 months, 2 patients occurred with nonunion (Garden type IV), 1 patient with femoral head necrosis (Garden type IV). All patients had no postoperative infection, internal fixation loosening, refracture and other complications.

Conclusions: In treating the young and middle-aged patients with femoral neck fracture, closed reduction and hollow compression screw fixation has advantages of simple, stable fixation, less trauma, high rate of fracture healing, osteonecrosis of the femoral head with low risk and satisfactory clinical effect.

Keywords: Closed reduction; Femoral neck fracture; Fracture fixation, internal; Hollow compression screws.