ABSTRACT
Objective To evaluate the potential high risk factors of femoral head necrosis after femoral neck surgery in adult patients. Methods From January 2009 to October 2014,390 patients with femoral neck fractures in our hospital were treated with multiple hollow compression screws. All patients were followed up for 12 to 60 months. Then retrospectively analyzed the incidence rates of femoral head nec-rosis and the clinical data about age,gender,fracture side,Garden index,fracture shift condition,internal medicine complications,whether to do lower limb preoperative traction,restoration method,postoperative load time and whether take out hollow compression screw internal fixa-tion,so as to explore the higher risk factors for femoral head necrosis. Results Among the 390 cases,352 cases got followed up. There were 45 cases of them ended with nonunionand 49 cases ended with femoral head necrosis. The univariate regression analysis results showed that the age,fracture shift condition,internal medicine complications,postoperative load time and Garden index,whether take out internal fixation were risk factors for femoral head necrosis (P<0. 05). The multi-factor results showed that aged from 40 to 60 years old,transfered fracture, seriously complications,time of loading less than 3 mouths,Ⅲ and Ⅳ Garden index,take out internal fixation were the high risk factors for femoral head necrosis (P<0. 05). Conclusion Patients who aged from 40 to 60 years old and having transfered fracture,seriously complica-tion,early weight bearing,high Garden index and internal fixation take-out would increase the risk of femoral head necrosis.
ABSTRACT
[Objective]To discuss the curative effect of using the DHSN and the sartorial-pedicled ilium bone graft in treating the fracture of neck of femur among young people.[Method]A total of 46 cases of the fracture of neck of femur treated with the DHSN and the sartorial-pedicled ilium bone graft were followed up for 1～8 years.The position of fracture or the area of bony defect was filled with the sartorial-pedicled ilium bone.[Result]The clinical results were assessed according to the functional rehabilitation.So,there were excellent results of 23 hips,good of 19 hips and poor of 4 hips in this study and the satisfactory rate was 91%.There were 44 cases reached osteal healing.The average healing time was 8 months and the average time of taken out was 14 moaths.[Conclusion]In treating the fracture of neck of femur among young people,the DHSN and the sartorial-pedicled ilium bone graft have the advantage of firm fixation and highly healing rate.
ABSTRACT
Femoral neck fracture has given marked attention to the orthopaedic surgeon due to complications, such as avascular necrosis of femoral head, non-union and degenerative arthritis, moveover common in older age group since early part of the 20th century. It is one of disabling and unsolved problems, so various techniques and implants were introduced and applied. Percutaneous Knowles pinning is one of simple, safe and reasonably effective method in treating femoral neck fracture, provided it is performed correctly. Nineteen cases of femoral neck fracture treated with precutaneous Knowles pinning at the Department of Orthopaedic Surgery, National Medical Center were analyzed and following result were obtained. l. Among the 19 cases, 13 cases were female and 6 cases were male, and high incidence was noted in older age group. 2. The amout of bleeding during operation was less than 100ml and the operative time was less than one and half hour under the local anesthesia in majority. 3. Good result was obtained in the group of operation less than 3 days after initial injury compared to more than 3 days group. 4. There was high complication rate in poor group than acceptable group according to Garden alignment index and we could predict the end result by aid of alignment index. 5. There was no cast immobilization in case of stable reduction, good fixation and good Rapport. 6. Bony union was established within 4.7 months in non-displaced fracture and 7.3 months in displaced fracture in average. 7. There were 1 case of avascular necrosis. 3 cases of non-union and 2 cases of degenerative osteoarthritis and poor results were correlated with Garden stage.