Treating The Freshness Displaced Femoral Neck Fracture In Young Adults With Sartorius Muscle Iliac Bone Flap Combined With Cannulated Screws

Objective Investigating the effectiveness of sartorius muscle iliac bone flapcombined with cannulated screws fixation in the treatment of freshness displacedfemoral neck fracture in young adults.Methods Retrospective analysis26young patients (experimental group) withfreshness displaced femoral neck fracture (Garden Ⅲ or Ⅳ type of under headfractures,neck fractures or medium neck fractures) from March2007to March2011who were treated by sartorius muscle iliac bone flap combined with cannulatedscrews fixation,28patients with same disease in the same period were treated bysimple open reduction internal fixation with cannulated screws as a control group.Results There was no significant difference in gender, age, injury cause, diseaseduration, Garden type and complication between two groups (P>0.05). All patientswere followed up3-7years (mean,4.1years). All of them achieved bone healingpostoperative3to6months.The quality of reduction by X-ray examination all weregradeⅠorⅠ-Ⅱ.There was no statistically difference between two groups in theincidence of avascular necrosis6months after operation (P>0.05), significantdifferences were found at24and36months (P <0.05). Harris hip scores at6and24months were no significantly differences in two groups (91.3±3.6vs89.3±3.7scores,P=0.059;90.1±5.1vs87.2±6.8scores, P=0.087); significant difference was found at36months(88.5±7.3vs80.5±13.1scores, P=0.008). There were no significantdifferences in postoperative blood loss, drainage volume, the incidence of incisioninfection, limb shortening, the injury of lateral femoral cutaneous nerve and internalfixation loosening between two groups (P>0.05), but the operation time in theexperimental group was longer than the control group（127.1±24.1vs102.8±12.2min, P<0.05）. There was no discomfort at the site of bone.Conclusion Sartorius muscle iliac bone flap combined with cannulated screwsfixation is the effective solution for the treatment of freshness displaced femoral neck fractures in young adults. It can reduce the incidence of avascular necrosis rate,and improve postoperative hip joint function.