Preliminary Clinical Efficacy Of Closed Reduction And Headless Cannulated Compression Screws For The Treatment Of Delbet-colonna ? And ? Femoral Neck Fractures In Children

Objective:To analyze the clinical efficacy of closed reduction and headless cannulated compression screws in the treatment of Delbet-Colonna ? and ? femoral neck fractures in children,and to provide a new option for the treatment.Methods:Nine cases of femoral neck fracture in children were taken from the year2014 May to 2018 March according to inclusion and exclusion criteria.Collecting and analyzing retrospectively about the clinical data of the patients whose femoral fractures were treated through closed reduction and headless cannulated screws.Meanwhile,all nine cases were followed up after operation,including the patients' symptoms,signs and related imaging examinations.Record the time of fracture healing,the incidence of complications,and the Harris score were used to evaluate the curative effect of femoral neck fracture after operation.To analyze the preliminary clinical effect of closed reduction and headless cannulated compression screws for the treatment of type Delbet-Colonna ? and ? femoral neck fractures in children.Results:There were five boys and four girls,aged three to fifteen,five on the left,and four on the right.Two cases were high falling injury,three cases were accident injury and four cases were slipping injury.According to the Delbet-Colonna classification,there were four type ? fractures and five type ? fractures.There were four cases with obvious displacement and five cases with slight displacement.Among them,three cases were combined with other injury,and the remaining six patients had not combined with any injury.The time they came to our hospital: there were six cases in one day,two cases in seven days,and one case in more than one week.The time between injury to operation:There were three cases in one day,and six cases were more than one day,with an average time of 65.56 h.The operative time was 35 to 120 minutes,with an average of(90.56±28.43)minutes.The intraoperative blood loss was 20 to 50 ml,with an average of(33.33 ± 8.50)ml.According to Haidukewych[26] standard of fracture reduction,four cases were excellent,accounting for 44%,five cases were good,accounting for 56%.The operative incision healed within fourteen days without incision infection or deep infection.All nine patients were followed up for 6 to 30 months,with an average follow-up time of(14.11 ± 8.12)months.During the follow-up period,all fractures were healed and the healing time was four to twelve weeks while the average healing time was(7.33 ± 3.53)weeks.Three months after operation,the hip function Harris score was 85 to 92 points,with an average of 89 ± 2.54 points.And five cases were excellent,accounting for 56%.Four cases were good,accounting for 44%.The hip function Harris score was 90 to 95 points with an average of 92.22 ± 1.69 points at six months postoperatively,including nine excellent cases.The final averaged Harris score was 92.89 ± 1.73 points.All patients had been removed the internal fixation device.During the follow-up period,there were no complications such as implant displacement ? malunion ? necrosis of femoral head and so on.Conclusion:Closed reduction and headless cannulated compression screws have good clinical effects in the treatment of Delbet-Colonna ? and ? femoral neck fractures in children.It has less blood loss?shorter operation time?shorter healing time?lower incidence of complications and better function.It can be used as a new choice for orthopedics doctors to treat children's Delbet-Colonna ??? femoral neck fractures.