The efficacy comparative analysis of cannulated screws for the treatment of femoral neck fractures in the elderly

doi:10.3877/cma.j.issn.2096-0263.2019.04.003

Abstract

Abstract:

Obejective

To observe the effect of internal fixation with cannulated screws in the treatment of patients over 65 years with femoral neck fractures.

Methods

Twenty five patients over 65 years met the inclusive and exclusive criteria from March 2012 to May 2017 were included in the observation group, and at the same time, 21 patients with femoral neck fractures under 65 years old were selected as the control group. Both groups were treated with closed reduction and cannulated screw fixation. The difference of clinical efficacy between the two groups was compared.

Results

In the observation group, 23 cases were followed up, 1 case occurred nonunion, 2 cases had avascular necrosis of the femoral head. 21 cases of the control group were followed up, 1 case had nonunion, 1 case had avascular necrosis of the femoral head, there was no significant difference between the two groups. The difference of Harris score has no statistically significant between the observation group(78±11) and control group (82±9) at 1 year postoperatively.

Conclusions

The treatment of cannulated femoral neck fractures with cannulated screws can still achieve the same therapeutic effect as femoral neck fractures in the lower age group.

Key words: Aged, Femoral neck fractures, Cannulated screws

jianguo Wu, lyuping Yin, yuqin Cai. The efficacy comparative analysis of cannulated screws for the treatment of femoral neck fractures in the elderly[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2019, 05(04): 196-200.

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References 13

1	Ye CY, Liu A, Xu MY, et al. Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness [J]. Chin Med J, 2016, 129(21): 2630-2638.
2	黄晓文,公茂琪,查晔军,等.早期快速闭合复位空心钉内固定治疗高龄股骨颈骨折的临床研究[J].中华老年骨科与康复电子杂志, 2017, 3(1): 4-10.
3	Pitto RP, Blunk J, Kössler M. Transesophageal echocardiography and clinical features of fat embolism during cemented total hip arthroplasty [J]. Archives of Orthopaedic & Trauma Surgery, 2000, 120(1/2): 53-58.
4	Blomfeldt R, Törnkvist H, Ponzer S, et al. Internal fixation versus hemiarthroplasty for displaced fractures of the femoral neck in elderly patients with severe cognitive impairment [J]. J Bone Joint Surg Br, 2005, 87(4): 523-529.
5	李涛,王英振,李玉龙,等.骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折安全性的Meta分析[J].中华老年骨科与康复电子杂志, 2017, 3(2): 109-115.
6	荣国威.应注意老年人新鲜股骨颈骨折治疗的选择[J].中华医学杂志, 2005, 85(46): 3241-3242.
7	翁蔚宗,李密,周启荣,等.髋部骨折流行病学分布特点:单中心2859例分析[J].第二军医大学学报, 2017, 38(4): 415-420.
8	李智勇,张奇,陈伟,等.难复位性股骨颈骨折的概念提出与治疗[J].中华创伤骨科杂志, 2011, 13(11): 1020-1023.
9	林绍仪,刘金伟,陈启康,等.双肌蒂髂骨瓣结合3枚空心钉治疗青壮年新鲜股骨颈骨折[J].临床骨科杂志, 2015, 18(5): 607-609.
10	宋国清,李小如,杨辉芳,等.有限开放加压螺纹钉内固定治疗高龄股骨颈骨折[J].湖南医科大学学报, 2001, 26(3): 277-278.
11	郭学峰,王裕民.老年股骨颈骨折的治疗进展[J].中国矫形外科杂志, 2014, 22(16): 1488-1491.
12	姚运峰,吕浩,张积森,等.经皮微创F形置入空心钉内固定治疗股骨颈骨折的早期疗效观察[J].中国骨与关节损伤杂志, 2014, 29(8):753-755.
13	危杰,毛玉江,贾正中.中空加压螺丝钉治疗新鲜股骨颈骨折212例[J].中华创伤杂志, 2000, 16(3): 142-144.

组别	例数	性别（例）		年龄（岁，±s）	按骨折线分型（例）			Garden分型（例）
组别	例数	男	女	年龄（岁，±s）	基底型	头颈型	经颈型	I	II	III
观察组	25	11	14	70±3	5	18	2	4	16	5
对照组	21	12	9	57±5	3	13	5	1	9	11
统计值		χ²=0.789		t=64.032	χ²=2.261			χ²=5.705
P值		>0.05		<0.05	>0.05			>0.05

组别	例数	性别（例）		年龄（岁，±s）	按骨折线分型（例）			Garden分型（例）
组别	例数	男	女	年龄（岁，±s）	基底型	头颈型	经颈型	I	II	III
观察组	25	11	14	70±3	5	18	2	4	16	5
对照组	21	12	9	57±5	3	13	5	1	9	11
统计值		χ²=0.789		t=64.032	χ²=2.261			χ²=5.705
P值		>0.05		<0.05	>0.05			>0.05

组别	例数	骨折不愈合[例（%）]	股骨头坏死[例（%）]	Harris评分（±s）
观察组	23	1（4.3）	2（8.6）	78±11
对照组	21	1（4.8）	1（4.8）	82±9
统计值		χ²=0.004	χ²=0.264	t=1.282
P值		>0.05	>0.05	>0.05

组别	例数	骨折不愈合[例（%）]	股骨头坏死[例（%）]	Harris评分（±s）
观察组	23	1（4.3）	2（8.6）	78±11
对照组	21	1（4.8）	1（4.8）	82±9
统计值		χ²=0.004	χ²=0.264	t=1.282
P值		>0.05	>0.05	>0.05

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