Early Clinical Efficacy Of Different Surgical Methods In The Treatment Of Young Adults With Femoral Neck Fractures

ObjectiveTo investigate and analyze the early overall clinical efficacy of closed reduction and cannulated screws fixation,open reduction and cannulated screws fixation and open reduction and cannulated screws fixation with autologous sacrum and artificial bone grafting for the treatment of young patients with femoral neck fractures.MethodsA total of 300 patients who underwent surgical treatment of femoral neck fractures in the Fourth Affiliated Hospital of Kunming Medical University from March 2013 to March 2018 were selected.Based on the inclusion and exclusion criteria,63 patients can be accepted.According to different surgical methods,24 patients who received closed reduction screw fixation were classified as group A,23 patients received open reduction screw fixation were classified as group B,and 17 patients received open reduction screw fixation with autologous sacrum Patients with mixed artificial bone grafts were classified as group C.Comparison of intraoperative bleeding volume,operation time,length of hospital stay,total hospitalization cost,total postoperative weight-bearing time,Harris score at last follow-up,postoperative complications(nonunion and femoral fractures)in group A and B?group B and C?group B and C.And analyzing the early clinical efficacy of different surgical methods in the treatment of young patients with femoral neck fractures.ResultsThere was no significant difference in baseline data between the three groups of study subjects(P<0.05).Compared with the patients who treated with the closed reduction and cannulated screws fixation,the patients with open reduction and cannulated screws fixation have greater surgical trauma(intraoperative blood loss,longer operation time),longer hospital stay,and more hospitalization costs.The total postoperative weight-bearing time is shorter and more effect of better fracture healing and less femoral head necrosis rate was significant(P<0.017),and there was no statistical difference in Harris score between the two groups at the last follow-up(P>0.017).Open reduction and cannulated screws fixation with autologous sacrum and artificial bone grafting group achieved better fracture healing effect and less femoral head necrosis rate than the group which achive the closed reduction and cannulated screws fixation.While,more costs will incurre.And the difference was statistically significant(P<0.017).There was a statistically significant difference in the amount of medium bleeding,operation time,length of hospital stay,and total postoperative weight bearing time(P<0.017).There was no significant difference in Harris score at the last follow-up(P<0.017).Open reduction and cannulated screws fixation with autologous sacrum and artificial bone grafting group achieved better fracture healing and less femoral head necrosis compared with patients in the open reduction and cannulated screws fixation,but it is more costs.There was a statistically significant difference in cost(P<0.017).There was no significant difference in the amount of medium bleeding,operation time,length of hospital stay,total postoperative weight bearing time,and Harris score at the last follow-up(P>0.017).ConclusionClosed reduction and cannulated screws fixation has less surgical trauma,shorter hospital stay and less hospitalization costs;Open reduction and cannulated screws fixation is superior to closed reduction and cannulated screws fixation in the incidence of postoperative nonunion and femoral head necrosis;Open reduction and cannulated screws fixation with autologous sacrum and artificial bone grafting can improve bone healing and reduce femoral head necrosis rate in the treatment of young patients with femoral neck fractures.