| Objective: To compare the effect of cannulated screw and DHS combined with anti rotation screw fixation in the treatment of non pathological fresh femoral neck fractures,and provide a basis for selection of internal fixation methods for patients with femoral neck fracture below 65 years old.Methods: From October 2015 to June 2017,38 cases of fresh non rational femoral neck fracture treated by closed reduction,cannulated compression screw,dynamic hip screw and anti rotation screw fixation were retrospectively analyzed.There were 18 cases of hollow compression screw group,including 10 male and 8 female;the age of 16-65 years and the average age of 54.9 years.There were 20 cases of DHS plus anti spiral screw group,of which 11 were male and 9 female,aged 50-65 years,with an average age of 58.0 years.There was no significant difference in the general data between the two groups(P>0.05).Main outcome measures included operative time,intraoperative blood loss,hospitalization time,fracture healing time,postoperative complication rate and hip Harris score at the last follow-up.The IBM SPSS 23 software was used to analyze the data and evaluate the curative effect and difference of the two surgical procedures.Results:Dynamic hip screw and the operation time of anti rotation screw group[(132.8 + 50.7)min] was significantly longer than the hollow screw group [(101.6 +42.8)min],the amount of bleeding in [(177.5 + 81.9)ml] were significantly more than hollow screw group [(67.2 + 55.4)ml],the differences were statistical significance(P<0.05).The time of hospitalization of the two groups was not statistically significant(P>0.05).The hollow screw group and dynamic hip screw and anti rotation screw group of patients with postoperative complication rate was[11.1%](2/18)and [5%](1/20),fracture healing time for [(3.8 + 0.7)months] and[(3.8 + 0.6)months],there were no statistical differences the significance(P> 0.05).However,the Harris score of the hip joint in the dynamic hip screw plus anti rotation screw group was significantly better than that in the hollow screw group atthe last follow-up [(86.3 + 9.3)points [(80.6 + 7.6)points],the difference was statistically significant(P<0.05).Conclusion: Dynamic hip screws and anti rotation screws are excellent in biomechanics.They have strong anchorage force,anti rotation and stable support function.They can effectively prevent loosening,internal fixation and varus deformity,and have fewer fluoroscopy times,which can be used for early functional exercise and ideal curative effect.The application of dynamic hip screw and closed reduction and internal fixation with anti rotation screw is an ideal treatment for Garden IV type femoral neck fracture under 65 years old,and it is worthy of clinical application. |
