微创空心加压螺钉联合内侧支撑板治疗青壮年Garden Ⅲ、Ⅳ型股骨颈骨折

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Abstract Objective To observe the clinical effect of open reduction with cannulated compression screw combined with medial support plate via direct anterior approach (DAA) in the treatment of Garden Ⅲ and Ⅳ femoral neck fractures in young adults. Methods Clinical data of 37 young patients with femoral neck fractures treated by cannulated compression screw combined with medial support plate via DAA approach in He′nan Luoyang Orthopedic Traumatological Hospita from November 2014 to September 2015 were enrolled in this retrospective study. Fracture healing and complications were followed up and observed. The hip function was evaluated by hip Harris score and the fracture reduction was evaluated by Garden reset index. Results In this study, 37 patients were followed up for more than 2 years. All patients achieved bone healing in 3-6 months after operation, the average healing time was (4.40±0.96) months. No loosening of internal fixation or displacement of fracture occurred. Two years after operation, one patient had osteonecrosis of the femoral head, then the conservative treatment was performed, the activity of the hip joint was not significantly affected. One patient experienced a decrease in sensation of the skin outside the thigh, which was considered to be caused by injury of the lateral femoral cutaneous nerve and was given the drug symptomatic treatment, and recovered after 5 months. The final follow-up of the Harris hip score was (89.66±4.52), which was significantly higher than the preoperative score (40.41 ± 6.98) (P ＜ 0.05). There was no significant difference in the Garden reset index between 3 d after operation and 2 years after the operation (P ＞ 0.05). Conclusion By using open reduction with hollow compression screw combined with medial support plate via DAA approach in the treatment of Garden Ⅲ and Ⅳ femoral neck fracture in young adults, the injury is small, the reduction is accurate and the internal fixation is firm, which is beneficial to early active rehabilitation after operation and to reduce the incidence of nonunion and necrosis of the femoral head. It is worth popularizing in clinic.

Key words： Direct anterior approach Medial support plate Cannulated compression screw Young adults Femoral neck fractures

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	WEN Yangyang1 LYV Jing1 SUN Hanrui1 FAN Ya′nan1 LI Wenlong2 JIA Yudong2 LIU Youwen2

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WEN Yangyang1 LYV Jing1 SUN Hanrui1 FAN Ya′nan1 LI Wenlong2 JIA Yudong2 LIU Youwen2. Minimally invasive with cannulated compression screw combined with medial support plate in young adults with Garden Ⅲ and Ⅳ femoral neck fractures[J]. 中国医药导报, 2018, 15(6): 67-70,79.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I6/67

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