Relationship Between External Fixation Time And Patients’ Prognosis After Femoral Neck Fracture With Internal Fixation

Objective:To compare the relationship between external fixation time and patients’ prognosis after femoral neck fracture with internal fixation.Methods:32 patients with femoral neck fracture in our hospital from January 2010 to January 2014 were been elected as the research subjects. There were 21 males and 11 females, aged from 19 to 60 with an average of 42.1, among them,15 cases were the left femoral neck fracture.17 cases were the right femoral neck fracture, Garden Ⅲ type in 10 cases and Garden Ⅳ type in 22 cases. All these patients were managed by open reduction and internal fixation that was supplemented with quadratus femoris muscle pedicle bone graft. We were use a brace for the patients at least three months in the postoperative time, we removed the brace and advise the patients active function training when the radiographs shows the fracture was healing and no tenderness, the rate of avascular necrosis of the femoral head (ANFH), nonunion, the joint function and bone density were recorded, the Harris score system was used to evaluate the function of the hip.Results:All patients were followed up for the average time for 32months(from 12 months to 60months), and the operational incisions obtained primary healing,31 of them achieved bone union and 1case delayed union,1 case developed into ANFH at the 2 year postoperative time. The bone density was compared among the different postoperative time. There was no difference between after surgery and postoperative 1 2 month(P>0.05), when we compared the bone density between postoperative 1 month and postoperative 3 month, postoperative 3 month had lower bone density(P<0.05), postoperative 1 month and postoperative 6 month had difference on bone density(P<0.05). According to the Harris standard, Compared the Harris score between postoperative 3 month and postoperative 6 month, postoperative 6 month had higher Harris score (P<0.05), when we compared the Harris score among postoperative 3 month, postoperative 6month and postoperative 12 month, postoperative 12 month had higher Harris score (P<0.05).There was no difference between before surgery and postoperative 12 month(P>0.05),and the Harris score level at postoperative 12 month 22 cases were excellent,8 cases were good, 1 in fair and 1 in poor when postoperative 12 month.Conclusion:To extend the external fixation time appropriately had low nonunion rate, low ANFH rate, Even had a lower Harris score and BMD in a short time, though Harris score and BMD had no difference between before surgery and postoperative 12 month.