Impact of open versus closed reduction hollow screw internal fixation on patients with femoral neck fractures
Objective To investigate the effects of open reduction with hollow screw internal fixation versus closed reduction with hollow screw internal fixation in patients with femoral neck fractures.Methods A total of 138 patients with femoral neck fractures admitted to No.215 Hospital of Shaanxi Nuclear Industry from January 2020 to June 2023 were selected and were divided into an open reduction group(68 cases)and a closed reduction group(70 cases)according to surgical methods.In the open reduction group,there were 36 males and 32 females,aged(48.77±5.23)years,and the Garden classification of fracture was type Ⅲ in 38 cases and type 1 in 30 cases.In the closed reduction group,there were 38 males and 32 females,aged(48.69±5.32)years,and the Garden classification of fracture was type Ⅲ in 36 cases and type Ⅳ in 34 cases.The closed reduction group received closed reduction hollow screw internal fixation,while the open reduction group received open reduction hollow screw internal fixation.The conditions of surgery and fracture healing,hip function and Visual Analogue Scale(VAS)scores 1,3,and 6 months after surgery,quality of life before surgery and 6 months after surgery,and postoperative complications were compared between the two groups.x2 test and t test were used.Results The surgery duration and intraoperative blood loss in the open reduction group were higher than those in the closed reduction group[(75.17±8.11)min vs.(62.87±7.54)min,(143.07±18.17)ml vs.(87.26±11.33)ml],and the intraoperative fluoroscopy uses and fracture healing time were lower than those in the closed reduction group[(25.69±2.59)times vs.(55.74±6.17)times,(3.83±0.33)months vs.(5.24±0.47)months],with statistically significant differences(all P＜0.001).Three and 6 months after surgery,the Harris hip scores in the open reduction group were(83.47±8.10)and(86.91±9.31)points,which were higher than those in the closed reduction group[(79.27±8.37)and(82.54±8.13)points],with statistically significant differences(both P＜0.05).One month after surgery,the VAS score in the open reduction group was higher than that in the closed reduction group[(2.84±0.44)points vs.(2.24±0.43)points](P＜0.05).Six months after surgery,the scores of physical function,role physical,physical pain,general health status,energy,social function,emotional function,and mental health of the SF-36 in the open reduction group were higher than those in the closed reduction group(all P＜0.05).The incidence of complications in the open reduction group was lower than that in the closed reduction group[1.5％(1/68)vs.10.0％(7/70)],with a statistically significant difference(x2=4.595,P=0.032).Conclusion Open reduction hollow screw internal fixation for treating femoral neck fractures offers better therapeutic outcomes and fewer complications compared to closed reduction hollow screw internal fixation,although it is associated with longer operation time,increased intraoperative blood loss,and greater short-term postoperative pain.
万方数据
维普
