The Effect Of Controllable Factors Within Femoral Neck Fracture’s Cannulated Screw Fixation On The Prognosis

Objective:Review and analysis the surgery and recovery of femoral neck fracture patients. Sum up the effect of the quality of surgical reduction, time between injury and surgery, start time of postoperative weight-bearing exercise on the prognosis of patients.Methods:Review medical records, telephone interviews, data of out-patient follow-up and inspection. Collect the treatment data and postoperative recovery data of the femoral neck fracture patients who got cannulated screw fixation surgery in Wuxi Chinese Medicine Hospital from January2006to December2008. Treatment information, including the quality of surgical reduction, time between injury and surgery, start time of postoperative weight-bearing exercise. Postoperative recovery include whether the nonunion, osteonecrosis, femoral neck shortening. There are117patients eligible throughout the follow-up. The nonunion rate, osteonecrosis rate, femoral neck shorten rate were2.56%,11.40%,23.76%. We group the patients based on the quality of surgical reduction, time between injury and surgery, start time of postoperative weight-bearing exercise. Specific grouping:According to reduction grade (Levell:Garden index: ap160°, lateral180°; Level2:Garden index:ap160°±5°, or lateral180°-185°; Level3: Garden index:ap160°±5°and lateral180°-185°; Level4:Garden index ap<155°, or lateral>185°). Contrast above factors’effect on the prognosis throughx2test.Results:The patients’femoral head necrosis rate and shortening rate of who got surgery within6hours after injury was significantly lower than who do after6hours (P<0.05). The patients’femoral head necrosis rate and shortening rate of whose reduction quality is higher than grade2was lower than patients of grade3-4(P<0.05). The patients’femoral neck shortening rate of who start weight-bearing exercise in two month after surgery is lower than the patients start in one month (P<0.05).The fracture nonunion rate is too low to sum up the controllable factors’affect on the rate of nonunion.Conclusion:The treatment of femoral neck fracture fixation should strive to be completed within6hours, the quality of reduction should arrive grade2. If can’t achieve grade2, we should consider the patient’s physical condition. If necessary, we should directly choose artificial joint replacement to avoid secondary surgery. The patient should do exercise on bed in2month after surgery and do weight-bearing exercise after2month.