Garden I-II femoral neck fracture treated with closed reduction and cannulated compression screw internal fixation: lateral position versus horizontal position

doi:10.3969/j.issn.2095-4344.1291

Abstract

Abstract:

BACKGROUND: Cannulated compression screw internal fixation is most common method for treating femoral neck fractures. Conventional supine position is difficult to carry out in primary hospitals because of its dependence on the traction bed, so it is difficult to be promoted.

OBJECTIVE: To compare the efficacy of lateral and horizontal positions with cannulated compression screw for the treating femoral neck fracture, and to provide evidence for intraoperative position selection.

METHODS: A retrospective analysis of 64 patients with Garden I-II femoral neck fractures admitted in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine from January 2013 to December 2015 was conducted. All patients were treated with cannulated screw fixation, and divided into two groups according to different positions (n=32 per group). The patients signed the informed consents and the study was approved by the ethics committee of hospital. Control group was given internal fixation treatment on the traction bed under the horizontal position, and trial group was treated with internal fixation on the ordinary operating bed (non-traction bed) under the lateral position. The surgical trauma (operation time, length of incision, intraoperative blood loss), treatment outcomes (post-bed time, fracture healing time and Harris score at postoperative 6 months) and complications were compared between two groups.

RESULTS AND CONCLUSION: (1) All patients were followed up for more than 6 months, and all achieved fracture healing. (2) The incision length, intraoperative blood loss, post-bed time, Harris score at postoperative 6 months and incidence of complications showed no significant difference between two groups (P > 0.05). (3) The operation time and preoperative waiting time in the trial group were significantly less than those in the control group, and the fluoroscopy times was significantly more than that in the control group (P < 0.01). (4) There was no significant difference in the incidence of postoperative complications between two groups (P > 0.05). (5) In summary, the treatment of femoral neck fracture with closed reduction and cannulated compression screw in the lateral and supine positions is similar in promoting postoperative hip function recovery, and no serious postoperative complications occur. Lateral position can effectively shorten the preoperative preparation time from anesthesia to incision, but the intraoperative radiation amount is higher than that in the horizontal position.

Key words: lateral position, supine position, femoral neck fracture, hollow compression screw, internal fixation, fracture healing, Harris hip score, blood loss

CLC Number:

R459.9|R683|R318

He Xiangzhong, Yang Wenbin, Lü Yang, Huang Junhan, Gao Shihua, Chen Haiyun, Liu Jun, Yu Xiubing. Garden I-II femoral neck fracture treated with closed reduction and cannulated compression screw internal fixation: lateral position versus horizontal position[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(28): 4497-4502.

Figures/Tables 4

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