Comparative Analysis About Detection Methods Of Blood Supply Of Femoral Head After Femoral Neck Fracture(with 15 Case Studies)

Objective: To compare the commonly used methods for detecting the blood supply of femoral head,and to evaluate the blood supply of femoral head after the femoral neck fracture,so as to select a simple,non-invasive and easily popularized method for detecting the blood supply of femoral head after the femoral neck fracture.Methods: Prospectively collect the patients with femoral neck fracture admitted to our hospital from January 2018 to January 2019,complete the informed consent and related examinations: preoperative pelvic X-ray,CT,super-selective angiography,dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),and successfully perform the closed reduction/open reduction and internal fixation + incision and decompression of capsula articularis coxae with articulatio coxae direct anterior approach(DAA),or total hip replacement.After the incision of the capsule,conduct the femoral head drilling to determine the blood supply of the femoral head before further operation.There are 15 cases with complete data.Before operation,take the super-selective angiography of medial and lateral circumflex femoral artery as a gold standard for blood supply detection,test the results of DCE-MRI and femoral head drilling for the detection of blood supply and the results of super-selective angiography by the rank sum test of classification variables,and conduct the correlation analysis between Garden classification results and the results of selective angiography.Results: There are 15 cases of femoral neck fracture,including 7 males and 8 females,with an average age of 57 years,Garden classification: 0 cases of type I,0 cases of type II,2 cases of type III and 13 cases of type IV.There is no correlation between the Garden classification and the detection results of femoral head blood supply(P > 0.05).There is no difference between DCE-MRI and super-selective angiography in the detection results of blood flow(P>0.05).There is no difference between femoral head drilling and super-selective angiography in the detection results of blood flow(P > 0.05).Conclusion: DCE-MRI can accurately determine the blood supply of patients,and it is most promising as a simple,non-invasive and easily popularized method to detect the blood supply of femoral head.Femoral head drilling can detect the blood supply of patients,and combined with DCE-MRI can more accurately evaluate the blood supply of femoral head.