Analysis of internal fixation failure after cannulated screws for adult femoral neck fracture

doi:10.3969/j.issn.2095-4344.2014.44.016

Abstract

Abstract:

BACKGROUND: Since cannulated screw has been applied to femoral neck fracture, it is not uncommon that the screw wear penetrates or refunds. What factors affect the stability of cannulated screw for treatment of femoral neck fractures in adults remains unclear.
OBJECTIVE: To explore factors related to internal fixation failure by cannulated screws in treatment of adult femoral neck fracture and improve the stability of the adult femoral neck fracture by cannulated screws.
METHODS: A total of 92 adult patients of femoral neck fracture were treated by cannulated screws in our department between June 2007 and June 2011. Their data were retrospectively analyzed. According to clinical information and follow-ups, we selected factors such as age, gender, Garden type of fracture, preoperative skeletal traction, timing of surgery, Garden index, standards of pedicle screws, pedicle screw shapes, partial weight bearing time and postoperative complications, which may affect the success rate of cannulated screws for
treating femoral neck fracture. The selected factors were then grouped and assigned, after unrelated factors were excluded by one-way χ2 analysis, multiariable Logistic regression analysis was performed.
RESULTS AND CONCLUSION: The involved 92 patients were followed up for 18-72 months. According to Harris assessment criteria, hip function was excellent in 28 cases, good in 25 cases, fair in 17 cases, and poor in 22 cases at the final follow-up, the excellent and good rate was 58%. Radiographic results showed that, the patients were divided into two groups according to the presence of the displacement, GardenⅠ (n=22) and GardenⅡ (n=29) as a group, and Garden Ⅲ (n=25) and Garden Ⅳ (n=16) as the other group, the fixation failure rate was 12% and 39%, respectively. In normol and abnormal Garden Index groups, the fixation failure rate was 16% and 59%, respectively. In nail position standards and non-attainment standards groups, the fixation failure rate was 19% and 70%, respectively. In the complication and non-complication groups, the fixation failure rate was 14% and 55%, respectively. These factor groups showed significant differences (P < 0.05). Multiariable Logistic regression analysis showed that, Garden type of fracture, Garden index, standards of pedicle screws, and postoperative complications are the risk factors for internal fixation failure using cannulated screws in treatment of the adult femoral neck fracture.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

CLC Number:

R318

Zhao Qi, Liu Shi-qing, Ming Jiang-hua, Zhou Yan, Liao Qi, Zhang Chun, Yang Yue. Analysis of internal fixation failure after cannulated screws for adult femoral neck fracture[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(44): 7138-7145.

Figures/Tables 5

References

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