Interactive homeopathic reduction for treatment of irreducible femoral neck fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the effect of homeopathic reduction technique in treatment of irreducible variant femoral neck fractures.Methods A retrospective case control study was performed for 91 cases of irreducible variant femoral neck fractures surgically treated from January 2011 to January 2014.Forty-seven cases [31 males,16 females;23-61 years,mean 40.6 years] were assigned to homeopathic reduction treatment (study group) and 44 [30 males,14 females;28-63 years,mean 43.1 years] were assigned to closed reduction and open reduction (control group).All fractures were Garden type Ⅳ.All cases were stabilized with three cannulated screws (6.5 mm in diameter).Operation time,intraoperative blood loss,Garden index for reduction quality,bone healing,complications like femoral head necrosis and Harris hip score were evaluated.Results Operation time and blood loss in study group [(41.2 ± 7.5) min,(37.3 ± 9.5) ml] were significantly lower than those in control group [(105.0 ± 15.7) min,(269.6 ± 50.6) ml] (P ＜ 0.05).Garden index was Grade Ⅰ 44 cases and Grade Ⅱ three in study group compared to Grade Ⅰ 20 and Grade Ⅱ three in control group (P ＜ 0.05).Incidence of femoral head necrosis had no significant differences between study group (four cases) and control group (10 cases) (P ＞ 0.05).Nonunion was not observed in study group,while there were eight cases of nonunion in control group (P ＜ 0.05).According to the Harris score,the excellent rate in study group was 91％ (39 excellent,four good,four fair) versus 66％ (21 excellent,eight good,15 fair) in control group (P ＜ 0.05).Conclusion Compared to closed reduction and open reduction,homeopathic reduction technique in treatment of femoral neck fractures is associated with shortened operation time,reduced blood loss,improved reduction quality and lowered incidence of necrosis and nonunion.