Comparison of a bidirectional-traction reduction device versus a traction table in treatment of femoral neck fractures with femoral neck system / 中华创伤骨科杂志

ABSTRACT

Objective:To compare the clinical efficacy between a bidirectional-traction reduction device and a traction table in the treatment of femoral neck fracture with femoral neck system (FNS).Methods:A retrospective study was conducted in the 46 patients with femoral neck fracture who had been treated at Department of Orthopedics, The First Central Hospital of Baoding from January 2020 to January 2021. There were 19 males and 27 females, aged from 30 to 64 years (average, 47.1 years). According to the Garden classification, 29 cases were type Ⅲ and 17 type Ⅳ. By the reduction method, the patients were assigned into an observation group ( n=24) in which the reduction was assisted by a bidirectional-traction reduction device and a control group ( n=22) in which the reduction was assisted by a traction table. FNS fixation was conducted in both groups. The 2 groups were compared in terms of operation time, reduction time, fluoroscopy frequency, intraoperative blood loss, femoral neck shortening at immediate postoperation and 12 months postoperation, Harris scores of the affected hip at 3, 6, and 12 months postoperation, and incidence of lower extremity venous thrombosis. Results:There were no significant differences in age, gender or fracture type between the 2 groups, showing they were comparable ( P>0.05). The observation group needed significantly less operation time [57.5 (54.0, 64.5) min], reduction time [(16.3±3.0) min] and fluoroscopy frequency [(20.5±4.6) times] than the control group did [85.0 (71.3, 92.0) min, (21.0±6.0) min and (29.7±4.7) times, respectively] (all P<0.05). There was no significant difference in intraoperative blood loss between 2 groups ( P>0.05). All patients were followed up for 12 to 22 months (average, 15.5 months). There was no significant difference in femoral neck shortening between the 2 groups at immediate postoperation or 12 months postoperation ( P>0.05). The Harris score of the affected hip in the observation group was significantly better than that in the control group at 3 months after surgery ( P<0.05), but such a significant difference was not observed at 6 or 12 months postoperation ( P>0.05). The incidence of thrombotic complications in the observation group (12.5%, 3/24) was significantly lower than that in the control group (40.9%, 9/22) ( P<0.05). Conclusions:In the FNS treatment of femoral neck fracture, compared with a traction table, reduction assisted by a bidirectional-traction reduction device is more advantageous because it is simpler and less time-consuming, incurs less fluoroscopy and leads to better early functional recovery of the affected hip and lower incidence of thrombotic complications.