Analysis Of The Curative Effect Of Computer Navigation-assisted Hollow Nail Internal Fixation In The Treatment Of Femoral Neck Fracture In Young People

Objective:To compare the clinical effect of cannulated screw fixation assisted by computer navigation system and conventional cannulated screw fixation in treatment of femoral neck fracture.Methods: A retrospective analysis was performed on the clinical data of patients with femoral neck fracture treated surgically in the Department of Orthopedics of Yan ’an University Hospital from January 2017 to December 2021.According to the inclusion and exclusion criteria,42 unilateral,fresh patients with femoral neck fracture younger than 65 years old were enrolled as subjects.There were 19 males and 23 females.There were 20 cases on the left side and 22 cases on the right side.According to Pauwels,15 cases were type ⅰ,15 cases were type ⅱ and 12 cases were type ⅲ.The average age was（40.58±8.12）years.According to the surgical methods,the patients were divided into the conventional group and the navigation group.The conventional group was treated with conventional closed reduction and hollow screw fixation,while the navigation group was treated with closed reduction and hollow screw fixation assisted by computer navigation.There were22 cases in conventional group and 20 cases in navigation group.The preoperative general data such as average age,gender,affected limb side and fracture type of patients in the two groups were statistically compared,and the results showed that there was no statistically significant difference between the data of the two groups（P>0.05）,which was comparable.The indexes related to intraoperative conditions of patients in the two groups were compared,mainly including: operative time,intraoperative fluoroscopy times,intraoperative guide wire placement times,intraoperative blood loss,postoperative length of hospital stay,intraoperative staff flow,and postoperative complications indicators,mainly including: Postoperative healing,postoperative necrosis of femoral head,and Harris Hip Score of patients at the last review were analyzed statistically.Results:Effective postoperative follow-up of 42 patients for 12-15 months found that there were 2 cases of nonunion in both groups,and 1 case of femoral head necrosis.In the last follow-up of the hip function examination score,the average score of the two groups were 86.5±3.2 and 89.2±2.8,respectively.The excellent and good rates were 77%and 80%,respectively,so there was no statistical difference in fracture nonunion,femoral head necrosis rate and hip function score（P>0.05）.In comparison of intraoperative conditions,the average intraoperative time was 71.82±8.73 minutes in the conventional group and 53.80±7.44 minutes in the navigation group.The average intraoperative fluoroscopy times were 19.68±3.14 times in the conventional group and 12.75±2.29 times in the navigation group.Comparison of the total mean times of the three guide wire implantation: 10.78±1.99 times in the conventional group and 8.95±1.65 times in the navigation group;The mean intraoperative blood loss was 32.5ml with a quartile spacing of 14 ml in the conventional group and 20.0ml with a quartile spacing of 6ml in the navigation group.For comparison,the mean in-and-out flow frequency of operating room related personnel was 21.0 times and 3.25 times in the conventional group,and 13.0 times and 3.75 times in the navigation group.The results of the above indicators showed statistically significant differences（P < 0.05）.The mean postoperative hospital stay was10.81±1.36 days in the conventional group and 10.78±2.10 days in the navigation group,with no statistical significance（P>0.05）.Conclusion:There was no significant difference in postoperative hospital stay,postoperative complications and long-term hip function between the computer navigation system assisted and conventional cannulated screw fixation for the treatment of femoral neck,and the clinical efficacy was good.But compared with the conventional surgical method,using the navigation auxiliary system of shorter operation time,less wear needle number,the area surrounding soft tissue in patients with intraoperative irritability and affect less blood supply,at the same time perspective,in and out of the operating frequency and less,to reduce the radiation exposure of patients and medical workers and the risk of iatrogenic pollution,It can reduce the economic burden of patients and optimize the allocation of resources,which is worthy of clinical promotion.