Clinical Observation Of Femoral Neck Reconstruction In Treatment On Femoral Neck Fracture Nonunion

Objective1、In order to have a deeper understanding in the treatment plan, the cases of femoral neck fracture nonunion by femoral neck reconstruction, whose clinical effects were retrospectively analyzed2、To discuss the role of Yishen Bugu and Huoxue Huayu Chinese medicine in the femoral neck fracture nonunion treatment.Methods29patients with nonunion of femoral neck fracture, in Traditional Chinese Medicine hip disease center of the First Affiliated Hospital of Guangzhou University, were managed with muscle bone flap or free bone reconstruction of femoral neck with3cannulated screw fixation combined with vascular bundle implantation with traditional Chinese medicine, from March2004to March2012.19males,10females, they range in age from15to55years, the average age is34.6years old. All fractures were closed fractures, the time from trauma to operation was3～27months, average time was10.1months. We mainly evaluate Harris function of the cases after treatment.ResultsThe results of Harris score after the treatment, the excellent and good rate was82.8%(24cases), effective rate was93.1%(27cases). Comparing the difference between the different factors influence the result of the treatment, reflects the possible impact of curative effect by the different factors on the femoral neck. According to the postoperative Harris score, the treatment of high falling injury is the best (P=0.041<0.05), the results of the traffic accident injury and the ground fall after treatment compared with before, were no significant difference. Compared with Garden Ⅰ and Ⅲ type, the Garden Ⅳ type fracture, which damaged the fracture ends and the blood flow around the femoral neck of more serious and caused greater chance for femoral neck fractures, bone nonunion, The clinical curative effect of femoral neck revascularization for Garden type Ⅳ was worse than Ⅱ, Ⅲ type, and postoperative treatment outcomes of type Ⅱ is optimal (P=0.026<0.05). The cases of femoral neck absorption within2cm.whose clinical effect was more excellent after femoral neck reconstruction treatment (P=0.012<0.05). Surgical repair patients, whose clinical effect after femoral neck reconstruction is better than patients who don’t have surgical repair (P=0.036<0.05). The time is6months to12months from the injury to the operation, clinical effect after femoral neck reconstruction is better than more than12months (P=0.036<0.05).ConclusionWith musculoskeletal flap or free bone block plus reconstruction femoral neck joint fixation of traditional Chinese medicine (TCM) and blood vessel bundle implantation for the treatment of femoral neck fracture, bone nonunion of clinical curative effect is remarkable. Harris function evaluation of satisfaction after femoral neck reconstruction, traditional Chinese medicine in the treatment of bone nonunion plays an important role. Revascularization can rebuild the femoral neck fracture of the femoral neck and mechanical support and their normal anatomic relationships, can help to restore the blood supply of femoral head, increase the rate of fracture healing, and finally can prevent or delay the artificial joint replacement, is an effective treatment method for the young and middle-aged femoral neck fracture bone nonunion.