Clinical Study On The Treatment Of Young Adult Femoral Neck Fracture With Hollow Cannulated Screw (HCS) Combined With Allograft Fibula (AF)

Objective: Comparison of hollow cannulated screws combined with allogeneic fibula and conventional three hollow cannulated screws in the treatment of young and middle aged femoral neck fracture,To provide reference for the treatment of femoral neck fracture in young and middle-aged patients by analyzing the Nagi femoral neck fracture efficacy evaluation criteria combined with Harris hip joint function score after operation.Methods: Observation from June 2013 to December 2015 in the Traumatic orthopedic department of The Third Hospital of Hebei Medical University,orthopedics random treated 44 cases of femoral neck fracture,All were Garden? type,32 cases of femoral neck fracture were fixed with three hollow cannulated screws(HCS),age 22-54 years old,average 36.6 years old.Injured to hospital time was 2 to 24 hours,an average of 6.8 hours.After the injury to the operation time of 40-72 hours,an average of 52.4±6.6 hours,12 cases were treated with the combination of the allograft fibula(AF)and the hollow cannulated screws(HCS)for the treatment of femoral neck fracture,age 20-52 years old,average 33.2years old.Injured to hospital time was 1.5 to 18 hours,an average of 5.4 hours.After the injury to the operation time of 42-78 hours,an average of 54.5±6.4 hours,There was no significant difference(P > 0.05)between the two groups of general data(age,the time of injury to hospital admission and the time of injury,etc.).The two groups were comparable,and all were closed reduction and internal fixation.Results: Two groups of patients have been followed up postoperatively,1 to 2.5 years follow-up time,average 15 months.Final follow-up by the system X-ray observation,Nagi femoral neck fracture efficacy evaluation criteria combined with Harris score standard,In the group of 3 hollow cannulated screws(HCS),X-ray film showed 28 cases of fracture healing,4 cases were healing incompletely,fracture healing time 3-6 months,average 4.8±1.0 months.Nagi femoral neck fracture efficacy evaluation criteria :Excellent in 17 cases,good in 7 cases,fair in 6 cases and poor in 2 cases.the excellent and good rate was 75%,Harris score was 74.34±16.23.IN the case of the two compression screws combine the allogeneic fibula,the bone broken line was Disappeared or fuzzy,there was no cases occured Internal fixationin displacement,fracture healing,The bone healing time was 3-6 months,average 4.2±0.6 months.Excellent in 9 cases,good in 2 cases,fair in 1 cases,the excellent and good rate was 91.7%,Harris score was 86.08±4.27,The rate of fracture healing,the evaluation of curative effect and the difference of the hip function at the last follow-up were statistically significant.Conclusions: For the Garden? type of the young patients with femoral neck fracture,through joint compression screws and allograft fibula(AF)rod treatment can make fracture ideal reduction,firm fixation,promote fracture healing,reducing the simple internal fixation often occurs in the femoral neck short shrink,the broken ends of the bone resorption,risk of nonunion and avascular necrosis of the femoral head fracture,It has certain clinical application.