Effect Evaluation Of DAA Approach Open Reduction And Internal Fixation In The Treatment Of Refractory Femoral Neck Fractures In Young Adults

Objective:To explore the clinical effect of open reduction and internal fixation through DAA approach in the treatment of refractory femoral neck fractures in young adultsMethods:Retrospective analysis of data from 31 patients treated with direct anterior approach(DAA)incisional internal fixation for femoral neck fractures between January 2016 and November 2020.There were 21 male patients and 10 female patients,with an average age of(49.80 ± 11.63)from15 to 71 years old.According to garden classification,they were all type IV;according to Pauwels classification,there were 10 cases of type II and 21 cases of type III.All patients underwent open reduction and internal fixation via DAA approach after failure of closed reduction.Fracture healing and avascular necrosis of the femoral head were evaluated by regular follow-up;fracture healing time was recorded;hip function recovery was evaluated according to Harris score;fracture reduction was evaluated according to garden index.Results:The average follow-up period was(10.3 ± 2.62)months(range,6-24months).During the follow-up period,one case of nonunion occurred(fracture healing rate,96.6%),and no avascular necrosis of the femoral head occurred.The average fracture healing time was(107.33 ± 32.743)days(range,90-270 days).The Harris score of the last hip joint was 76-98(range,91.8 ± 4.9),22 cases were excellent,7 cases were good,The excellent and good rate was 93.54%.There was no significant difference in garden index between the two postoperativesConclusion:Direct anterior approach(DAA)open reduction and internal fixation for the treatment of refractory femoral neck fractures in young adults is simple and easy to expose,does not damage the blood supply of the femoral head,and can obtain anatomical or approximate anatomical reduction of the fracture.The incidence of nonunion and avascular necrosis of the femoral head is low,and the clinical effect is good.Direct anterior hip approach(DAA)is recommended for open reduction of femoral neck fractures...