Operative treatment of fresh femoral neck fracture in the youth and middle-aged

Objective To retrospectively study the operative treatments for the young and middle aged cases of fresh femoral neck fractures. Methods There were 72 cases in the group, with an average age of 34.4 years (20 48 years). 22 cases were sub head fractures, 32 cases trans neck ones and 18 cases basal neck ones. They were all fixated by 3 titanium alloy cannulated screws. 51 cases were treated by closed reduction, 21 cases by open reduction together with either bone graft with quadratus femoris or iliac graft with deep circumflex iliac vessels. Patients were followed up for an average of 3 years and 4 months. Results 5 cases obtained poor reduction (4 cases nonunion), and 10 cases suffered from femoral head necrosis. Conclusions The principles for the treatment of fresh femoral neck fracture are early treatment, anatomic reduction and rigid fixation. The treatment with 3 titanium alloy cannulated screws in the form of isosceles triangle possesses the merits of excellent fixation, dynamic compression, high healing rate, less lesion and fewer complications, and the screws can be kept in the body for a long time. Iliac graft pedicled with muscle or blood vessel can efficiently improve local blood supply. Better fracture reduction, earlier activities and later weight bearing will decrease the incidence of femoral head necrosis.