Comparison In Clinical Efficacy Of Two Minimally Invasive Surgical Methods In Treatment Of Pauwels Type Ⅲ Femoral Neck Fractures In Young Adults

Objective:Compare the clinical efficacy of transverse screw combined with three cannulated screws and three cannulated screw fixation in the therapy of Pauwels type III femoral neck fractures in young adults,to further provide theoretical basis for the treatment of femoral neck fracture.Methods: From June 2017 to June 2020 were conforming Pauwels type III femoral neck fractures.A total of 43 patients with femoral neck fracture,were divided into two groups according to surgical strategy.Specific as follows,17 patients in the group A received transverse screw combined with three cannulated screws fixation,and 26 patients in the group B were treated with three cannulated screw fixation.For the cases in two groups of the operation time,fracture reduction quality,intraoperative blood loss,fracture healing time,the last follow-up Harris scoring,and presence of complications,and so on and so forth to make comparison and analysis of the results.Results: Patients in the two groups were followed up for 8 to 13 months,10.82±1.42 months for group A and 10.96 ± 1.22 months for group B.Specific information is compared as follows:The comparison in terms of operative time was no significant difference(Group A 55.53 ± 10.90 min,group B 52.69 ± 5.75min)(P>0.05).The comparison in terms of fracture reduction quality was no significant difference.(P>0.05).The comparison of intraoperative blood loss also was no significant difference(41.94±4.42 ml in group A and 40.08±5.44 ml in group B)(P>0.05).However the comparison of fracture healing time was obvious difference between the two(15.29± 2.23 weeks in group A and 19.23 ± 2.98 weeks in group B)(P<0.05).When we compared the Harris score at the last follow-up found that Group A was significantly higher than group B(90.35±3.08 points in group A and 81.12±3.23 points in group B)(P<0.05).The comparison of postoperative complications was different,and it’s statistically significant.(P<0.05).In group A,femoral head necrosis occurred in 1 case,in group B,delayed union occurred in 1 case,cannulated screw withdrawal and internal fixation failure occurred in 1 case,femoral neck shortening occurred in 4 cases,and femoral head necrosis occurred in 2 case.Conclusion: To compare with the method of three cannulated screw fixation,transverse screw combined with three cannulated screws can better resist vertical shear force,shorten fracture healing time,reduce postoperative complications and improve hip function.This study can provide a new method of Pauwels type III femoral neck fractures in young adults.