A Comparative Study Between Dynamic Hip Screw Blade With Cannulated Compression Screw For Treating Femoral Neck Fractures

Objective To compare the clinical curative effect of dynamic hip screw blade andcannulated compression screw in treating patients with fresh femoral neck fracture andto discuss the value of the femoral neck fracture treated with DHS-BLADE.Methods We compared retrospectively the patients with femoral neck fractures treat-ed by using closed reduction internal fixation with DHS-BLADE and cannulatedcompression screw between March2011to August2013in the First Affiliated Hospitalof Dalian Medical University, orthopedic trauma. Patients met the inclusion criteriawere86cases in which cannulated screw group (A group)44cases, DHS-BLADE(group B)42cases. Group A: included20males,24females; aging26to83years,mean age53.8years old; according Garden classification: type I0case, type Ⅱ20cases, type Ⅲ16cases, type Ⅳ8cases. Group B: included18males and24fe-males; aging37to87years, mean age56.3years; according to Garden classification:type I0case, type Ⅱ24cases, type Ⅲ13cases,type Ⅳ5cases. Reviewing medi-cal records, patient follow-up and telephone interviews were retrospectively summa-rized.The main analysis of two groups of patients with surgical time, incision size,hospitalization days, as well as related complications, Harris hip score.Results1.The patients were followed up from6months to24months with an averageof15.2months.2.The A group: mean operative time (47.2±18.6) minutes, The B group:mean operative time of (43.4±20) minutes; The average incision size of group A were(3.6±1.5) cm, and group B were (4.2±1.8) cm, mean blood loss of group A was (32.4±24.7) ml, and group B was (87.2±46.6) ml, the average hospital stay of group Awas (5.6±2.8) days, and group B was (6.1±2.2) days. there was no significant differencein surgery time, incision size (P>0.05). Group A had less amount of bleeding, the dif-ference was statistically significant (P<0.05).3. There were no complications such asinfection, deep vein thrombosis of the lower limps, plate or screw fracture, hip varus inboth groups. Group A2/44cases (4.5%) appeared nonunion, Group B had no nonunion;Group A:4/44cases (9.1%) avascular necrosis, Ⅲ phase1case，Ⅳ phase3cases，and group B had3/42cases (7.1%) avascular necrosis, Ⅱ phase1case，Ⅲ phase2cases, there was no significant differences in the rate of nonunion, avascular necrosi（sP＞0.05）.14/44cases (31.8%) occurred femur neck shortening in group A, Grade I7cases, Grade II4cases, Grade III3cases, significantly shortening rate (shortening>1cm)of15.9%, while11/42cases (26.2%) occurred femoral neck shortening in group B,Grade I10cases, Grade II1case, Grade III0case, significantly shortening rate of2.4%,there was no significant differences in the rate of femoral neck shortening,but differ-ence in significantly shortening rate was statistically significant (P<0.05). The group Ahad2/44cases (4.5%) screw cut out, and group B had no screw cut out cases, the dif-ference wasn’t statistically significant (P＞0.05).The group A had10/44cases (22.7%)screws loosening, and group B had2/42cases (4.76%) screw loosening, group B hasobvious advantages compare with group A in screw loosening(P<0.05).4. Harris hipscores: Group A:80.4±9.3points, excellent and good rate were73%; Group B:86.1±8.4points, excellent and good rate were88%, the difference was not statisticallysignificant (P>0.05).Conclusion In the treatment of femoral neck fracture, cannulated compression screwsand DHS-BLADE both achieved a high rate of fracture healing, and in the prevention offemoral neck shortening, screws loosening and screw cut-out, DHS-BLADE had signif-icant advantages.