Comparison Of Different Characteristic Cannulated Screws For The Treatment Of Femoral Neck Fractures

ObjectiveTo evaluate the outcomes of treatment of internal fixation with two different characteristic cannulated screws for the femoral neck fractures, analyze the benefits and drawbacks of the two different characteristic cannulated screws. Materials and MethodsFrom January 2002 to October 2006, 78 patients aged from 29 to 90 with a femoral neck fracture (Garden typeⅠ,Ⅱ,III and IV) were enrolled in Xuanwu hospital after excluding patients who were lost or refused to cooperate. In case of 78 patients with fracture of the neck of the femur, 35 patients underwent closed reduction and internal fixation with three AO(ASIF0) cannulated screws, while 43 patients received closed reduction and internal fixation with three Depuy cannulated screws. Then, we collected the general information of patients not only including age, the type of fracture, and comorbidities, but also the mean time elapsed between injury and surgical treatment and the variance of Singh index. Compared the variance of the max one of the included angles among the screws and the total of the included angles between the two different screws, the variance of the total of the distances among the screws, evaluated the diversities of qualified percentage of the distances from the articular surface of the femoral head to the distal end of the screws. We calculated the variance of the qualified percentage and superordinary score of the two different screws for the treatment of the femoral neck fractures. We reviewed the different of hospitalization days, duration of surgery, and the mean time from surgery to hospital discharge. At last, blood loss, blood transfusion, and complications are calculated besides cost of treatment excluding any subsequent admission in both groups.ResultsThere is no statistical difference between the mean age(61.4, 62.7 respectively), gender, the type of fracture, the variance of Singh index in both groups.Though group B has a shorter length of surgery(85.58±21.66minutes versus 90.28±23.69minutes ), a shorter length from operation to hospital discharge(9.5±3.2days versus 8.7±2.7days),a shorter hospitalization days(12.7±5.1days versus15.1±5.2days), there is no statistical difference between the two internal fixation groups with different characteristic cannulated screws, and there are no patients to transfuse blood in the two internal fixation groups.According to the measured outcomes from those post-operation X-images,we find group B has an advantage over group A on qualified percentage (86.0% versus 65.7% P<0.05) and superordinary score(7.88 versus 7.26 P<0.05); there is a significant variance statistically on the max one of the included angles among the screws and the total of the included angles between the two different characteristic screws, but there is no variance statistically on the total of the distances among the screws between group A and group B, and the qualified percentage of the distances from the articular surface of the femoral head to the distal end of the screws between the two groups has no statistically variance.When we forced guide pins from a side with the mechanics-experiment machine and drew two loading-bias curves, obtained two regression equations:Y(torque)= 0.027+0.117X(bias)(AO) and Y(torque)=0.002+0.216X (bias)(Depuy). ConclusionsIn conclusion, both the two different types cannulated screws can attain to the standard of the femoral neck fracture internal fixating, relieve pain, and improve fracture healing. In contrast, Depuy screws are apt to have better outcomes than the AO cannulated screws.