Comparative Analysis Of Early Clinical Effects Of Femoral Reconstruction Nail And Hollow Nail Combined With Femoral Retrograde Intramedullary Nail In The Treatment Of Femoral Shaft With Ipsilateral Femoral Neck Fracture

Objective:Comparison of early clinical effects of femoral reconstruction nail and hollow nail combined with retrograde femoral intramedullary nail in the treatment of femoral shaft with ipsilateral femoral neck fracture.Methods:We collected data of patients with femoral shaft and ipsilateral femoral neck fractures who were admitted to our hospital from May 2012 to April 2018.We selected 35 patients with intact patient data and retrospectively analyzed the data.19 of them underwent femoral reconstruction.Patients with internal fixation were classified as group A,and 16 patients who underwent femoral neck cannulated screw combined with femoral retrograde intramedullary nail were assigned to group B.The gender,age,waiting time,total hospital stay,and hospitalization were compared between the two groups.Total cost,time spent on surgery,intraoperative blood loss,intraoperative fluoroscopy,and excellent follow-up Harris hip function score,total weight-bearing time,total complication rate,and associated complication rate(femoral neck or femoral shaft)The effects of these two methods in the treatment of femoral shaft and ipsilateral femoral neck fractures were compared between the two methods: nonunion of the fracture,necrosis of the femoral head,knee joint stiffness,and knee stiffness.Results:There were statistically significant differences between the two groups in terms of total hospitalization cost,time spent on surgery,intraoperative blood loss,intraoperative fluoroscopy,and excellent rate of Harris hip function score at the last follow-up,ie,P<0.05;There was no significant difference in the length of hospital stay and the total postoperative complication rate,ie P>0.05.There was no significant difference in the incidence of complications associated with postoperative femoral neck fractures in patients with non-displaced femoral neck before surgery,ie,P>0.05;for patients with significant femoral neck displacement before surgery,B Theincidence of complications associated with femoral neck was lower in group than in group A,and the difference was statistically significant(P<0.05).Conclusious:In the choice of internal fixation for patients with femoral shaft and ipsilateral femoral neck fracture,the internal fixation should be selected according to the degree of displacement of the femoral neck fracture.For the preoperative femoral neck fracture without displacement of the femoral shaft combined with the ipsilateral In patients with femoral neck fractures,the use of femoral reconstruction nails to fix two fractures at one time is superior to the use of cannulated screws combined with femoral retrograde intramedullary nails to fix two fractures.However,patients with femoral neck fracture displacement before surgery,patients with two fractures fixed with cannulated screws and femoral retrograde intramedullary nails at the last follow-up Harris excellent hip function score and femoral neck nonunion or malunion In terms of the incidence of symptoms,it is better than the choice of patients with femoral reconstruction nails and fixation of two fractures.There was no significant difference in the two internal fixation methods for the probability of postoperative femoral deformity healing or non-union.