Analysis The Reasons Of The Femoral Neck Fracture Internal Fixation Failure And Its Treatment Countermeasures

Objective:To investigate the causes for failure of internal fixation in treatment of femoral neck fracture when using cannulated compression screws and proximal femur anatomic plate,and to investigate the clinical application and effect of total hip arthroplasty.Follow-up the functional recovery of hip, improvement of the pain,walking ability and recovery of lower extremity biomechanical function after the operation of total hip arthroplasty.Methods:Collected29femoral neck fracture cases treated with total hip arthroplasty after failure of internal fixation from Renmin hospital of Wuhan University and Hubei hosptial of TCM from March2010to June2011.According to cases of inclusion criteria and excluded patients criteria,select23cases of integrity of clinical data.The group contains15cases of male and8cases of female/the ages rage from43to76,the average age is57.6year. To23femoral neck fracture cases treated with total hip arthroplasty who occur with hip pain, lameness, even those unable to walk after failure of internal fixation.Evaluate therapeutic effect with Harris standards according to preoperative and postoperative X-ray and postoperative functional recovery of the hip jointResults:Collected29femoral neck fracture cases treated with total hip arthroplasty after failure of internal fixation in all.According to cases of inclusion criteria and excluded patients criteria,select23cases of integrity of clinical data.The patients were followed up for6-13months, and9months on average.All of23cases’incisions healed well.Three paitents felt slight pain in their ipsilateral hips6months after operations when they were walking,but the pain relieved after symptomatic treatments.There is no complication of serious pain,dysfunction,early dislocation, loosening and rupture of the prosthesis in other cases.According to Harris scoring,the hip functions were excellent in20cases, and good in3cases;the score before operation is48.82±8.85,but84.78±4.99after operation, there is a signigicant difference with statistical analysis.Conclusion:Efficacy of total hip arthroplasty in the treatment of neck fracture cases after failure of internal fixation is satisfied.Total hip arthroplasty can avoid the complication after the failure of internal fixation in treatment of femoral neck fracture when using cannulated compression screws and proximal femur anatomic plate effectively save the hip function after the failure of femoral neck fracture using internal fixation, relieve pain, recover the lower extremity biomechanical function,improve the quality of life in patients,but we should prevent complications actively,guide the joint functional exercise, improve the effect of surgery,recover the lower extremity biomechanical function,improve the quality of life in patients.