2023, Vol. 27 ›› Issue (4): 583-587

Comparison of dynamic hip screw and anti-rotation screw internal fixation and femoral neck system internal fixation in the treatment of Garden II-IV femoral neck fracture

Hong Xiao1, Luo Hong1, Yang Ruonan2   

Abstract: BACKGROUND:   The biomechanical strength of dynamic hip screw plus anti-rotation screw internal fixation for femoral neck fracture is higher than that of cannulated screw, but it fails to reflect the principle of minimally invasive surgery. Femoral neck system with minimally invasive surgery for the treatment of femoral neck fractures has few surgical complications, strong postoperative stability and good outcomes, and can reduce the incidence of complications such as internal fixation failure and fracture displacement.
OBJECTIVE: To compare the short-term effects of dynamic hip screw plus anti-rotation screw internal fixation and femoral neck system internal fixation in the treatment of Garden II-IV femoral neck fracture.
METHODS: Totally 93 patients with Garden II-IV femoral neck fractures in the Guizhou Orthopedic Hospital from January 2019 to February 2021 were enrolled in this study. They were at the age of 24-79 years. All patients were randomly divided into control group (n=43) and trial group (n=50). The control group was implanted with dynamic hip screws and anti-rotation screws for fracture fixation and reduction, while the trial group was implanted with femoral neck system for fracture fixation and reduction. The incision size, blood loss, operation time, fluoroscopy times, and fracture reduction were recorded in both groups. Fracture healing time, Harris score, visual analogue scale score, the incidence of complications, and the rate of reoperation in the two groups were observed after operation.
RESULTS AND CONCLUSION: (1) Incision length, blood loss, operation time, and fluoroscopy times were less in the trial group than those in the control group (P < 0.05). The fracture reduction was good in both groups, and there was no significant difference between the two groups (P > 0.05). (2) Both groups completed the 6-month postoperative follow-up. There was no significant difference in the incidence of internal fixation failure, fracture nonunion and femoral head necrosis between the two groups (P > 0.05). There was no significant difference in the total incidence of postoperative complications and reoperation rate between the two groups (P > 0.05). (3) There was no significant difference in the fracture healing time between the two groups (P > 0.05). Harris score and visual analogue scale score 6 months after treatment in the two groups were significantly improved compared with those before treatment (P < 0.05). There was no significant difference in Harris score and visual analogue scale score between the two groups 6 months postoperatively (P > 0.05). (4) These findings suggest that the mechanical properties of dynamic hip screw plus screw and femoral neck system are good, but the advantages of femoral neck system internal fixation are simple operation, less fluoroscopy, short operation time, less trauma and less bleeding.
Key words: dynamic hip screw, anti-rotation screw, femoral neck system, femoral neck fracture, internal fixation, curative effect