Hip Replacement And Application Of Cannulated Screws In The Treatment Of Femoral Neck Fractures.

Objective: To evaluate the hip replacement and clinical efficacy in the treatment of femoral neck fracture with cannulated screws, and then the principles of treatment were discussed in femoral neck fractures.Methods:To regressively analyze the patients of Department of Orthopaedics , Changchun Central Hospital from January of 2005 to January of 2010 ,there were 133 cases of femoral neck fractures.Surgical technique, postoperative outcome and complications were analyzed according to all kinds of injurys of femoral neck fracture in the operation of hip replacement and cannulated screws.Results: In these cases 1) 46 cases were joint arthroplasty, including 10 cases of hip replacement , 36 cases of bipolar femoral head replacement,.The average age were 76.The average time in hospital was 19.2±1.51 days, The average of time on operation was 53.18 minutes, average blood loss was 258.17ml, The average amount of blood transfusion was 320.36ml. 13 cases got prosthesis loosening, 6 cases got infection , 8 cases got deep vein thrombosis, 5 cases had hip ache, 3 cases had joint dislocation .2 cases got stress ulcer. Harris rate was 76% .2)Internal fixation was used in 36 cases, the average age was 53.5, Time in hospital was 18.2±1.30 days,The average time on operation was 41.32 minutes, Average blood loss was 48.9ml, Only 2 patients had blood transfusions,and the amount was 100ml. Femur head necrosis occurred in 9 patients after surgery, Hip replacement in 4 cases, 3 cases had femoral head replacement; 7 cases got deep vein thrombosis on leg, 1 case got prosthesis infection. Harris rate was 63.8%, The two groups had significantly difference. (P <0.05). Conclusion: For those had non-displaced fracture of the femoral neck who live independently below GardenⅢand those can not take care of themselves three- cannulated -screws fixation were operated。Between the age of 60-75 , femoral neck or femoral head displaced above GardenⅢphysically good, no symptom of coexistence or just one coexistence disease,well controlled patients,hybrid hip replacement were operated. For over 60 years old with displaced femoral neck fracture, above GardenⅢ, physically normal or poor, more than one coexistence disease,bipolar femoral head were replaced. We should pay attention to the exercise of function of the hip after operation, effectively prevented the occurrence of postoperative complications with concerns on the recovery of hip function.