| Objective:With the rapid development of China's economy,transportation and industry,the incidence of femoral neck fracture in young and middle-aged people is gradually rising.The treatment of femoral neck fracture with hollow pressure screw technology has been recognized by most experts at home and abroad.However,there is still some debates about the spatial configuration of the hollow pressurized screw implantation.On the one hand,this paper discusses which spatial configuration of the hollow pressurized screw implantation is better for the strong fixation and healing of fractures by consulting relevant literatures.Through clinical analysis and comparison,on the other hand,we analysised and compared aspects of intraoperative and postoperative follow-up analysis between the traditional operation method(The conventional guide use a 2.5mm kirschner needle to guide the internal fixation of the hollow pressurized screw)and the improved surgical method(An improved guide with an enlarged aperture of 3.6mm and a 3.5mm steiner needle replacement technique to guide the hollow pressurized screw)in the treatment of middle-aged and young patients with femoral neck fracture.Now there are many different types of clinical guiding devices.According to the improved surgical methods in our department,whether there are more advantages in screw placement efficiency and accuracy compared with traditional surgical methods in terms of the design and surgical skills of the improved guide device,so as to find a better surgical treatment method and further improve the clinical efficacy.Methods:1.consult,organize related literature,and analysis of different space configuration of hollow compression screws in the treatment of femoral neck fracture,to find which kind of space configuration can achieve stronger fixation,better effect after decocting,and the best configuration.Study and absorb the advantages and disadvantages of different guide clinical to improve the shortage of the traditional orientation.2.Retrospective study was conducted to collect patients who were admitted to the orthopedic ward of baoding first central hospital and diagnosed with femoral neck fracture between December 2014 and May 2019;Both groups were treated with inverted internal fixation and followed up regularly.142 cases were included and divided into observation group and control group.In the observation group,there were 71 patients(40 males and 31 females)with a modified guide with a diameter of 3.6mm(to facilitate the passage of a 3.5mm thick needle)and the technique of gass' s needle replacement to guide the treatment of femoral neck fractures with hollow pressurized screws.The control group used 2.5mm kirschner needle to guide the conventional guide device with the internal fixation technique of hollow pressure screw,and a total of 71 patients,39 males and 32 females,were treated.Age inclusion criteria were 18 to 65.There were 33 cases of left femoral neck fractures in the observation group,38 cases of right femoral neck fractures,31 cases of left femoral neck fractures in the control group,and 40 cases of right femoral neck fractures.Femoral neck fracture is classified by Garden type,In the observation group,there were 5 cases of ? type,7 cases of ? type,45 cases of ? type,14 cases of type ?.,In the control group there were 4 cases of ? type,8 cases of ? type,43 cases of ? type,16 cases of type.All patients were followed up for 9 months.The operation time,intraoperative blood loss,intraoperative fluoroscopy times,fracture healing time and the last follow-up survey of the two groups were counted and Harris functional score was used to evaluate the efficacy.Results:The baseline datas between the observation group and the control group were not statistically significant(P>0.05).Therefore,the surgical methods of the observation group and the control group were comparable.The mean operation time and intraoperative fluoroscopy times of the two groups all achieved statistically significant differences(P<0.05),indicating that the advantages of surgical methods in the observation group were significantly better than those in the control group.Intraoperative blood loss in the two groups were not statistically different(P>0.05).patients in the two groups were given regular dressing change,reasonable functional exercise,and regular follow-up after surgery.It was found that fracture healing time and hip Harris score p value between the two groups were not statisticallysignificant(P>0.05).Conclusion:1.the improved guide whose pore size is 3.6 mm,combined the 3.5 mm needle replacement technology,to induct the hollow compression screws in treating femoral neck fractures,can achieve obvious advantages in reducing operstion time and the number of intraoperative fluoroscopy,and can improve the cannulated screw placement accuracy,compared with traditional guidance of 2.5 mm hollow compression screw internal fixation.2.Three hollow pressure screws were used to treat femoral neck fractures and were placed in an inverted "pin" shape,which was more advantageous than the "pin" shape placement in biomechanics,strong fixation and promoting fracture healing. |
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