2023, Vol. 27 ›› Issue (36): 5823-5827

Comparison of femoral neck internal fixation system and simple cannulated screw internal fixation in the treatment of femoral neck fractures in patients under 65 years old

Zhao Jun, Chen Changsheng, Xu Zhonghua, Chen Hongfeng, Zhang Feng, Wang Qiuping, Zhou Jinlong, Que Yunduan   

Abstract: BACKGROUND: For many years, the choice of internal fixation for femoral neck fractures in young adults has been controversial. No matter what treatment is chosen, the goal is the anatomical reduction and stable internal fixation. Although there are many internal fixation methods for the treatment of femoral neck fractures in young adults, the therapeutic effects have their advantages and disadvantages, and there is no unified treatment plan at present.  
OBJECTIVE: To observe the effect of a new type of femoral neck internal fixation system in the treatment of femoral neck fractures.
METHODS: From January 2019 to June 2020, the relevant data of 21 patients with femoral neck fractures fixed by femoral neck internal fixation system (observation group) and 32 patients with femoral neck fractures fixed by three hollow nails (control group) were included in this study. The patient age was ≤ 65 years old. All patients had closed fractures. All patients underwent anteroposterior radiography of the affected side before the operation, and all patients underwent a CT plain scan plus three-dimensional reconstruction. Fracture healing and necrosis of the femoral head were evaluated by X-ray film of the hip joint after the operation. MRI examination was performed in some cases when necessary. The hip function was assessed at the last follow-up.  
RESULTS AND CONCLUSION: (1) All 21 patients in the observation group were followed up for an average of 19 months. The average operation time was 58.09 minutes. The average number of fluoroscopy was 23.19 times. The average intraoperative blood loss was 109.29 mL. The average clinical healing time was 3.86 months. The mean time of complete weight bearing after the operation was 6 months. The complication rate was 14.3%. The excellent and good rate of hip joint function was 85.7%. (2) In the control group, 32 patients were followed up for an average of 18 months. The average operation time was 74.06 minutes. The average number of fluoroscopy was 33.41 times. The average intraoperative blood loss was 81.56 mL. The average clinical healing time was 4.69 months. The mean time of complete weight bearing after the operation was 6.72 months. The complication rate was 28.1%. The rate of excellent and good hip function was 71.9%. (3) The results show that compared with the simple cannulated screw internal fixation, the femoral neck internal fixation system can shorten the operation time and clinical healing time of patients with femoral neck fractures under 65 years old, and reduce the frequency of fluoroscopy.

Key words: femoral neck fracture, femoral neck internal fixation system, cannulated screw, young and middle-aged, femoral head necrosis, femoral neck shortening