Percutaneous internal fixation of hollow screw Ti-nails in treatment of femoral neck fracture: Curative effect and host response in a follow-up analysis of 57 cases / 中国组织工程研究

ABSTRACT

AIM: To investigate the clinic effect of the femoral neck fracture (FNF) with percutaneous internal fixation of hollow screw Ti-nails. METHODS: A total of 57 patients with closed FNF were recruited from Department of Orthopaedics in the First Mine Hospital of Pingdingshan Coal Group from February 2001 to December 2005. They were treated with 3 hollow screw Ti-nails (produce by Shanghai Qunli Medical Devices Co., Ltd) in 5-mm diameter under C-arm X-ray monitoring after close reduction by hand, punctured with 4-6 bone round nails in 2.5-mm diameter through skin for prefixation. The patients were encouraged to stretch and flex muscles early and perform articular physiological movement. The criteria of outcomes: Excellent the patients were completely cured in six months after surgery, no pain was found in diseased coxa, the articular movement was normal, and they could walk freely half one year after surgey. Good The fracture was cured in 9 months lately or no healing, there was a little ache in diseased coxa, the articular movement was limited, and they could walk normally in 10-12 months after surgery and recover slight work. Bad The fractures were not cured, there were absorption, shifting, and aching in fracture joint early, and they need walk with walking stick. RESULTS: There were 55 cases followed up for 9 months, 51 cases for 18 months, and 57 cases for 42 months.①The curative effect of FNF by internal fixation was excellent in 27 cases, good in 20 cases and bad in 10 cases. ②Host response 6 patients suffered from fracture shift due to screw-nail displacement, 4 patients got bone un-union, 6 patients experienced femoral head necrosis, and 2 patients got ache at bone fracture and were limited for articulation movement. No infection and rejection happened among 57 patients. CONCLUSION: The treatment of AO cannula Ti-screws internal fixation under closed reduction is effective for FNF, and no abnormal biocompatibility between materials and host appears in the clinical follow-up.