Comparative study of two different surgical methods for the treatment of Garden Ⅲ and Ⅳ femoral neck fractures in young adults
10.3760/cma.j.issn.1001-2036.2018.05.004
- VernacularTitle:中青年GardenⅢ和IV型股骨颈骨折两种手术方法的对比研究
- Author:
Dong ZHANG
1
;
Aixi YU
;
Guorong YU
;
Shengxiang TAO
;
Zhengyu PAN
;
Baiwen QI
;
Weidong XIAO
;
Kai DENG
;
Zonghuan LI
Author Information
1. 武汉大学中南医院显微骨科
- Keywords:
Femoral neck fracture;
Garden type;
Internal fixation;
Bone graft;
Transposition
- From:
Chinese Journal of Microsurgery
2018;41(5):428-432
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare internal fixation with hallow compression screws combined vascularized bone graft(observation group) with only three hallow compression screws(control group) in young patients' Garden III and IV femoral neck fractures. Methods The patients with femoral neck fracture were treated from January, 2004 to December, 2013 were retrospectively reviewed. A total of 417 displaced femoral neck fractures in young and mid-dle-aged patients were long term followed-up. One hundred and thirty-seven patients were underwent open reduction and internal fixation with 3 hallow compression screws combined with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery;280 patients were treated by closed reduction with 3 hallow com-pression screws. Results Patients had been followed-up for 5-12 years. At the last follow-up point, the Harris score of flap in observation group(93.68±5.12) were higher than that in control group(92.53±6.12), while it was no sta-tistical difference(P>0.05). It was 0.7％of nonunion incidence rate in the observation group, and incidence of avascular necrosis of femoral head was 6.6％, and incidence of femoral neck shortening was 8.8％. In the control group, inci-dence of avascular necrosis of femoral head was 14.6％, nonunion incidence rate was 4.6％, and incidence of femoral neck shortening was 22.5％. The differences between two groups was statistically significance( P<0.05). Conclusion The open reduction and internal fixation which is hallow compression screws in combination with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery is an optimal treatment for young adults with Garden III and IV femoral neck fractures.
