The Clinical Reseach Of Femoral Neck Fracture Treated By The Two Approaches

Objective:To study the treatment effect of open reduction and hollow tensionscrew internal fixation treated the fracture of femoral neck by smallanterior incision approach and traditional lateral approach.To selection ofsurgical approach for femoral neck fracture internal fixation andprovide a basis for the later research.Methods:Retrospective study the result of treatment which178patients withfemoral neck fracture caused by trauma during october2010to november2012. Selection criteria:41cases which closed reduction failure thenopen reduction and hollow tension screw internal fixation treated thefracture of femoral neck by small anterior incision approach andtraditional lateral approach. In41patients male24cases consist offemale17cases, The average age of48.5years old,ranging in age from21to58years, The femoral neck fracture resulted from amotor vehicle22cases,Fall down17,Falling injury from a high position4cases.TheGarden Ⅱ type in2cases, Garden type Ⅲ29cases, and Garden Ⅳ10cases.Head type9cases, jugular type27cases, basal type5cases.adduction type23cases. The middle type7cases, outreach in11cases. put41patients hands into the can be divided into A, B two groupsby approach.Group A:25cases adopts the traditional lateral incision (thepart of Wason-Jones approach).Group B:16cases adopts the front ofsmall incision (part of the Smith-Peterson approach). average follow-upof18months (minimum6months, the longest30months). All cases are fresh fracture.The operations were performed between1and7days afterinjury.Statistics:Statistical software package for data processing using SPSS13.0(IBM,the USA).Measurement data is reported as means±SD. Comparisonswere made between different treatment groups and determined byANOVA, A value of P <0.05was considered significant.Results:Group B compared with group A shorter operation time,intraoperative blood loss less.Group B than in group A femoral neck nohealing complications, femoral head necrosis, no difference.Group A andgroup B in hospital time difference and the Harris score between threegroups of patients (walk score, activity score) difference had no statisticalsignificance.Garden index is closely related to the rate of fracture healing.Conclusions:The displaced femoral neck fractueres treated by the anteriorincision does not lower the incidence of the osteonecrosis of femoral headand nonunion, but the anterior incision can obviously decrease thesurgical trauma, surgical time, surgical bleed. However, the anteriorincision posses the advantage of less trauma, less perioperative bleedingand rapid recovery.