C-arm hip fluoroscopy at primary position in the internal fixation of femoral neck fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To evaluate the hip C-arm fluoroscopy at primary position in internal fixation of femoral neck fracture.Methods:A retrospective study was conducted of the 69 patients with femoral neck fracture who had been treated from August 2015 to August 2018.They were divided into a primary position group ( n=35) subjected to C-arm hip fluoroscopy at primary position under symmetry traction of bilateral lower limbs for reduction of femoral neck fracture and a control group ( n=34) subjected to C-arm hip fluoroscopy at frog’s position on the healthy side for traction and reduction of the injured hip. The 2 groups were compared in terms of fluoroscopy frequency, times of resetting guide pin, intraoperative blood loss and total operation time. Results:The 2 groups were comparable due to insignificant significances between them in the preoperative general data like gender, age, fracture type, injury cause, or interval from injury to operation ( P>0.05). Compared with the control group, the primary position group showed less intraoperative fluoroscopy (7.2 times ± 0.5 times versus 16.1 times ± 1.2 times), fewer times of resetting guide pin (2.1 times ± 0.31 times versus 4.7 times ± 0.8 times), less intraoperative blood loss (96.8 mL ± 18.6 mL versus 198.1 mL ± 13.2 mL), and shorter total operation time (1.2 h ± 0.2 h versus 1.6 h ± 0.3 h). All the differences were statistically significant ( P<0.05). Conclusions:C-arm hip fluoroscopy at primary position may protect the stability after fracture reduction because bilateral lower limbs are under symmetrical traction and the hip position needs no alteration. Operation of C-arm fluoroscopy is easy and convenient and produces clear images. Therefore, this new mode of fluoroscopy has advantages of less intraoperative fluoroscopy and guide pin resetting, leading to significantly reduced intraoperative blood loss, ineffective operation time and anesthesia time.