Clinical Observation Of Two Kinds Of Screw Internal Fixation For Femoral Neck Fracture

ObjectiveHollow compression screw is currently the classic internal fixation scheme for the treatment of femoral neck fractures.As a new type of internal fixation scheme for femoral neck fracture,full-thread screws are gradually gaining clinical application.Through retrospective analysis,this study compared the efficacy of full-thread screws and hollow compression screws in the treatment of femoral neck fractures,and provided clinical and theoretical references for the selection of internal fixation screws.MethodsRetrospective analysis of 54 patients with femoral neck fractures diagnosed and treated in our hospital from September 2016 to February 2018.According to the different methods of internal fixation,they were divided into two groups.Patients in group A(n=28)were treated with closed reduction fracture internal fixation with hollow compression screws.Patients in group B(n=26)were treated with closed reduction fracture internal fixation with full-thread screws.To compare and analyze the general preoperative data,operation time,intraoperative blood loss,intraoperative fluoroscopy,postoperative pain score,hip harris function score,Garden reduction index,femoral neck shortening rate and femoral head necrosis rate in two groups by statistical software.Results(1)Comparing the preoperative general data of the two groups of patients,the difference was not statistically significant(P>0.05).(2)The operation time of group A was(89.86±10.950)min,the operation time of group B was(93.42±9.352)min;the intraoperative blood loss in group A was(116.43±14.333)ml,the intraoperative blood loss in group B was(113.69±14.797)ml;the number of intraoperative fluoroscopy in group A was(11.92±1.742)times,the number of intraoperative fluoroscopy in group B was(11.92±1.742)times.There was no statistically significant difference between the basic conditions of the two groups of patients(including operation time,intraoperative blood loss,intraoperative fluoroscopy number)(P>0.05).(3)There was no significant difference in the VAS pain score between the two groups of patients at 1 month after operation(P>0.05),patients in group B had significantly lower VAS pain scores than those in group A at 3 months and 6 months after operation,the difference was statistically significant(P<0.05).There was no statistically significant difference in harris score of hip joint function between the two groups of patients at 3 months after operation(P>0.05),the harris score of hip joint function in group B patients was significantly higher than that in group A at 6 months and 12 months after operation,the difference was statistically significant(P<0.05).(4)There was no statistically significant difference between the two groups of patients after 3 days of Garden Index(P>0.05),the difference between the two groups in the Garden index at 6 months after operation was statistically significant(P<0.05).(5)The shortening rate of femoral neck in group B(7.692%)was significantly lower than that in group A(32.143%),the difference was statistically significant(P<0.05).Compared with group B(3.846%),the femoral head necrosis rate in group A(3.571%)was not statistically significant(P>0.05).Conclusion(1)Both full-thread screws and hollow compression screws are effective internal fixation methods for the treatment of femoral neck fractures.(2)Full-thread screws can significantly reduce the incidence of postoperative femoral neck shortening;after fracture reduction,it is more advantageous to maintain the stability of fracture.(3)Full-thread screws are beneficial for postoperative pain relief and hip function recovery.(4)Full-thread screws will not increase the operation time,intraoperative blood loss,and intraoperative fluoroscopy times;it cannot reduce the risk of postoperative femoral head necrosis.