Analysis of effect of five years after internal fixation with cannulated screws in femoral neck fracture

Abstract

Objective To investigate the postoperative long-term efficacy and related factors of postoperative complications of femoral neck fracture. Methods A total of 103 patients of femoral neck fracture fresh and closed were collected from January 2010 to September 2012.Follow-up observation was performed on 82 cases with complete data of more than five years after operation. Gender, age, injury violence, Garden type, the number of cannulated screws, operation method, Garden index, ambulation time, whether to internal fixation removal, Harris score and femoral neck nonunion, femoral head necrosis and shortening of the femoral neck are counted.Logistic regression was used to analyze these factors. Results The mean age of 82 patients was(49±6)years and the average follow-up was (77±4) months. There were 31 cases of femoral head necrosis and necrosis rate was 37.8%. Asymptomatic rate was 54.84% among them. Eleven cases occurred femoral neck nounion in which 10 cases accepted the total hip replacement, and the nounion rate was 13.41%. In 35 cases, the femoral neck was shortened with a short shrinkage of 42.68%. At the end of the follow-up, the good rate of Harris score was 71.08%. Analysis of related risk factors of femoral head necrosis showed that the injury violence[OR=0.029, 95%CI (0.003, 1.336), P=0.005], Garden type[OR=18.27, 95%CI (1.547, 215.77), P=0.021], surgical methods[OR=8.567, 95%CI(1.739, 42.204), P=0.008] and reduction quality [OR=0.125, 95%CI (0.024, 0.657), P=0.014] were significant. The results of the nonunion of the femoral neck (Wald χ2=4.471, P=0.034) and the results of the femoral neck shortening (Wald χ2=10.255, P=0.001) showed that the reduction quality was significant influence factor. Conclusions Efffect of cannulated screw internal fixation treatment of femoral neck fracture after long-term follow-up is satisfaction, but the incidence of shortening of the femoral neck is high.The reduction quality is significantly associated with these three complications. Key words: Femoral neck fractures; Fracture fixation, internal; Femur head necrosis; Fractures, ununited; Treatment outcome