Case Control Study on Proximal Femoral Cannulated Screw Locking Plate Compressed by Cannulated Compression Screw and Cannulated Screws in Treating Young Adults with Femoral Neck Fractures
Abstract：Objective To compare the short-term clinical effects of proximal femoral cannulated screw locking plate compressed by cannulated compression screw and cannulated screws in treating young adults with femoral neck fractures.Methods The clinical data of 56 cases with femoral neck fracture treated in our hospital from January 2013 to January 2015 were analyzed retrospectively.The patients were divided into two groups(group A and B)based on the different fixation method.Of them，30 cases(group A，18 males and 12 females)were treated with proximal femoral cannulated screw locking plate compressed by cannulated compression screw and 26 cases(group B，15 males and 11 females)with three compressed canulated screws.Operative time，intraoperative blood loss，healing time of fracture，incidence of non union and femoral head necrosis，incidence of failure fixation，joint function (Harris score)were compared between two groups，and statistical analysis was performed.Results All 56 patients were followed up from 18 to 30 months with an average of 24 months.There was no significant differences in incidence of non union and femoral head necrosis between two groups(P＞0.05).Operative time of group A (94.70±4.96)min was more than that of group B (67.30±5.65)min (P＜0.05).Intraoperative blood loss of group A (144.27±26.42)mL was more than that of group B (77.73±7.86)mL (P＜0.05).Healing time of fracture of group A (11.33±1.09)months was less than that of group B(13.19±1.27)months (P＜0.05).In group A，there were no internal fixation failure cases；and in group B，screw retreating occurred in 3 cases，screw cutout from the femoral head occurred in 2 cases；there was significant differences between the two groups(P＜0.05).Joint function (Harris score) of group A (80.87±2.55) was higher than that of group B(79.30±2.96) (P＜0.05).Conclusion Proximal femoral cannulated screw locking plate compressed by cannulated compression screw has advantages of reliable fixation in treatment of femoral neck fractures.Compared with the traditional three compressed canulated screws，proximal femoral cannulated screw locking plate compressed by cannulated compression screw has less healing time and fixation failure rate and higher hip function scoring.But this operation mode is more complicated，the operation time is prolonged and the amount of Intraoperative blood loss is increased.
王桂华，冯玉旭，谭力，王梅生，陈福扬. 辅助加压股骨近端空心钉锁定板与空心加压钉治疗股骨颈骨折的疗效分析[J]. 实用骨科杂志, 2017, 23(12): 1073-1077.
Wang Guihua，Feng Yuxu，Tan Li，et al. Case Control Study on Proximal Femoral Cannulated Screw Locking Plate Compressed by Cannulated Compression Screw and Cannulated Screws in Treating Young Adults with Femoral Neck Fractures. sygkzz, 2017, 23(12): 1073-1077.
［1］Reigstad O，Siewers P.Excellent long-term survival of an uncemented press-fit stem and screw cup in young patients：follow-up of 75 hips for 15-18 years ［J］.Acta Orthop，2008，79(2)：194-202.
［2］Rodríguezmerchán EC.In situ fixation of nondisplaced intracapsular fractures of the proximal femur［J］.Clin Orthop Relat Res，2002(399)：42-51.
［3］Yu XB，Zhao DW.Prospective and comparative analysis of internal fixation of femoral neck fractures with or without vascularized iliac graft in young adults［J］.Orthopedics，2013，36(2)：132-138.
［4］中华医学会骨科分会.预防骨科大手术深静脉血栓形成指南［J］.中国矫形外科杂志，2009，17(2)：118-120.
［5］Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures：treatment by mold arthroplasty.An end-result study using a new method of result evaluation［J］.J Bone Joint Surg (Am)，1969，51(4)：737-755.
［6］Selvan VT，Oakley MJ.Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures：a biomechanical study［J］.Injury，2004，35 (2)：136-141.
［7］Sa?lam N，Küçükdurmaz F.Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures［J］.Acta Orthop Traumatol Turc，2014，48(2)：196-201.
［8］俞银贤，马金忠，朱力波，等.55岁以下成年移位股骨颈骨折内固定术后失败的研究分析［J］.中国骨伤，2012，25(7)：542-545.
［9］Bhuyan BK.Augmented osteosynthesis with tensor fascia latae muscle pedicle bone grafting in neglected femoral neck fracture［J］.Indian J Orthop.2012，46 (4)：439-446.
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