A Comparative Study Of DAA Approach And S-P Approach In The Treatment Of Refractory Femoral Neck Fractures In Young Adults

Objective: To explore the clinical effect of direct anterior approach(DAA approach)and traditional S-P approach(Smith Peterson approach)in the treatment of refractory femoral neck fractures in young adults.Method: 61 patients with femoral neck fracture who met the inclusion criteria from January 2015 to January 2019 were collected from the First Affiliated Hospital of Nanchang University.They were divided into DAA group,including 12 patients with garden ?,16 patients with garden ? and 33 patients with S-P,group including 15 patients with garden ? and 18 patients with garden ?,which were divided into DAAG ?,DAAG ?,S-PG ? and S-PG ? Group.Through retrospective study,the general data(gender,age,injury side),incision length,injury to operation time,operation time,intraoperative blood loss,average length of stay,VAS score of postoperative pain,positive side index of garden,postoperative complications and Harris score of hip joint function in DAA group were compared and analyzed.To compare the clinical effect of the two groups.Result: The patients in the four groups were followed up for 12-36 months,with an average of 26 months.There was no significant difference between DAA group and S-P group in basic data(gender,age,injured side)(P> 0.05).There was no significant difference between DAA group and S-P group(P > 0.05)in the time from injury to operation and the average days in hospital.There was significant difference between DAA group and S-P group in the time from operation,the amount of bleeding during operation and the VAS pain score one day after operation(P < 0.05).There were significant differences between DAA ? group and S-P ? group in the time from operation,the amount of bleeding during operation,the VAS pain score of 1 day after operation and the VAS score of 5 days after operation(P < 0.05).There was no significant difference between DAAG ? group and S-P ? group,DAAG ? group and S-PG ? group(P > 0.05).There was a significant difference between DAAG ? group and S-P ? group,DAAG ? group and S-PG ? group in positive garden index and Harris of hip joint function in June and December(P < 0.05).At 24 months followup,there was a case of femoral necrosis in DAAG IV group,S-PG ? group and S-PG IV group.Conclusion: Compared with the S-P approach,DAA approach has the advantages of shorter incision,shorter operation time and less intraoperative blood loss compared with the S-P approach in the treatment of young and hard to recover femoral neck fracture,and the long-term effect of reduction of femoral neck fracture is slightly better than the S-P approach,which can be used as one of the optimal surgical methods in clinical treatment of young and hard to recover femoral neck fracture.