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BACKGROUND:The key difference between closed reduction and open reduction for femoral neck fracture is the incision of joint capsule or not. As for this problem, scholars have different opinions, but there is no unified conclusion. OBJECTIVE:To compare reduction quality and the rate of femoral head necrosis of open reduction and closed reduction in the treatment of femoral neck fracture in middle-aged and young patients with displaced femoral neck fracture. METHODS: Clinical data of 102 middle-aged and young patients with femoral neck fracture, who were treated in the Department of Traumatic Orthopedics, Guizhou Orthopedic Hospital from June 2008 to June 2014, were analyzed. They were folowed up. According to the manner of reduction, they were divided into open reduction group (n=39) and closed reduction group (n=63). General data, postoperative fracture healing, the rate of femoral head necrosis and reduction quality were compared between the two groups. RESULTS AND CONCLUSION:No significant difference in general information, preoperative and postoperative hemoglobin difference, fracture healing time and fracture nonunion rate was detected between the two groups (P > 0.05). The rate of femoral head necrosis was lower in the open reduction group than in the closed reduction group, but reduction quality was higher in the open reduction group than in the closed reduction group (P < 0.05). These results indicate that in the treatment of displaced femoral neck fractures in middle-aged and young patients, postoperative femoral head necrosis rate of open reduction and fixation is low, and the quality of reduction is better. Open reduction has a certain advantage, but the case number and case study have a certain limitation. We should choose the appropriate way of operation treatment according to the patient’s condition.
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Objective To explore the sluice gate technology in the control of nutrient vessel retrograde island skin flap with sural nerve small saphenous vein blood flow.Methods Totally 32 cases were divided into group A and group B,group A flap with no special treatment to the return of small saphenous vein,group B applied river gate principle,in operation around the small saphenous vein reserved suture,postoperative through a rubber band traction control flap blood circulation and skin flap swelling. Observation and comparison of two groups of skin flap necrosis.Results There had 4 cases in group A flap incomplete necrosis,the incidence rate was 25.0%,1 cases of skin flap incomplete necrosis in B group,the incidence rate was 6.2%.Conclusion The use ofsluice gate technique to control the small saphenous vein reflux of blood,relieve skin flap swelling,improve the survival rate of the flap is simple and effective.
