The Analyses Of Internal Fixation With Compressed Cannulated Screws Of Femoral Neck Fractures

Objective: To evaluate the clinical effectiveness of treatment of femoral neck fractures by internal fixation with cannulated compression screws and to investigate the related factors influencing the nonunion and avascular necrosis of femoral head after surgery.Methods:From Jan.2001to Jan.2010,119cases of the femoral neck fractures were treated with reduction and cannulated compression screws internal fixation in our hospital, collected the clinical information and follow-up. Besides review analysis the clinical and radiographic data of the patients and analysis factors as patients’ gender, age, fracture type, reduction quality and duration to surgery to find correlations with nonunion and femoral head necrosis.Results:119patients were followed up ranging from32to137months and the mean time was80.2months. The fracture healed in114cases, nonunion rate was4.2%; femoral head necrosis in12cases and the rate was10.1%. The functional evaluation of hip joints according to Harris Hip Score (HHS) was as follows: excellent in8lcases, good in21cases, moderate in7cases, poor in1Ocases, fine rate was85.7%. No other serious complications. The incidence of avascular necrosis of femoral head in nondisplaced fracture group and displaced group were2.27%and14.67%respectively, there was significant difference between the two groups (P=0.025). The incidence of nonunion of femoral head in anatomical reduction group and non-anatomical reduction group were1.27%and10.00%. The incidence of avascular necrosis of femoral head were2.53%and25.00%respectively; also, significant difference was existed both between the two groups(P=0.043, P=0.00030). However, there was no statistically significant difference of nonunion and necrosis of femoral head according to sex, age, operative time.Conclusion:Cannulated compression screws fixation is a reliable method for the treatment of femoral fracture with a high rate. The fracture type and reduction quality are found to be main factors correlated with nonunion and avascular necrosis of femoral head statistically. For young patients with femoral neck fracture, in order to avoid incidence of nonunion and necrosis of femoral head, anatomical reduction and stable internal fixation should be ensured.