| Objective: Depending on the surgical approach and internal fixation device,the contrast analysis of young and middle-aged Pauwels Ⅲ type femoral neck fracture cannulated screw fixation and pure hollow screw joint medial support plate line(DAA)fixed curative effect,provide guidance for clinical treatment.Methods: The clinical data of 76 patients treated with cannulated screw fixation alone or cannulated screw combined with medial bracing plate in our hospital from January2015 to January 2019 were retrospectively analyzed.There were 42 males and 34 females with an age of(44.46±6.64)years.The collected cases were unilateral femoral neck fracture,with 39 cases on the left side and 37 cases on the right side.According to the two surgical methods of closed or open reduction,35 patients in the observation group received cannulated screws combined with medial bracing plate,while 41 patients in the control group received cannulated screws alone.The operative time(min),intraoperative blood loss(ml),fracture healing time(weeks),weight bearing time(weeks),hip function score(Harris),postoperative visual analog scale(VAS),and the risk of postoperative complications such as infection were compared between the screw group and the screw combined with medial plate group.Therefore,the clinical effect of simple cannulated screw fixation and cannulated screw combined with medial plate fixation was analyzed.Results: The follow-up time of the two groups ranged from 16 to 18 months(mean17.24 months).The operative time of patients in the cannulated screw combined with medial bracing plate group was(124.26 ± 13.19)min,and the operative time in the cannulated screw group was(77.41 ± 12.86)min,and the operative time in the cannulated screw combined with medial bracing plate group was longer,and the difference was statistically significant(P < 0.05).In terms of intraoperative bleeding,the intraoperative bleeding was(131.09±35.29)ml in the cannulated screw combined with medial plate group.Compared with the former group,the blood loss in the simple screw fixation group was(92.02±22.27)less,and the difference was statistically significant(P< 0.05).The indexes of fracture healing and weight-bearing in the two groups were analyzed.The healing time of the former was(16.37±0.97)weeks,and the walking time of the lower ground was(18.36±1.68)weeks significantly shorter than that of the latter(18.15±1.53)weeks and(23.72±1.96)weeks,with statistical significance(P < 0.05).In the cannulated nail combined with inner plate group,1 case had internal fixation failure(screw removal),and 2 cases had superficial infection of the incision.The complications in the cannulated screw group were poor fracture healing in 4 cases,failure of internal fixation in 5 cases and necrosis of femoral head in 4 cases.As can be seen from the complications,the number of complications in the cannulated screw group was more than that in the single cannulated screw group(P < 0.05).In the case of adequate follow-up,there was a higher rate of excellent and good hip function(Harris)in the nail-combined medial plate group(82%,73%,P < 0.05).VAS scores 3 and 6 months after hip fracture were lower in the cannulated screw group(P < 0.05).Conclusion: Results show that directly into the path of the side line(DAA)hollow screw joint medial plate internal fixation for the treatment of middle-aged and young Pauwels Ⅲ type are better than on the clinical effect of the treatment of femoral neck fracture of the hollow screw fixation,can better promote fracture healing and the hip joint function recovery,and less postoperative complications,is a kind of new way of operation. |
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