Therapeutic effect of open and closed reduction with cannulated screw fixation in displaced femoral neck fracture

Objective To compare the effect of open and closed reduction with three cannulated screw fixation in displaced femoral neck fracture. Methods Fifty one patients with displaced femoral neck fracture from January 2006 to January 2013 were selected. Thirty two cases were treated with closed reduction and three cannulated screw fixation(closed reduction group),while 19 cases were treated with open reduction and it(open reduction group). The operation time, intraoperative bleeding,intraoperative fluoroscopy time, Harris hip function score at the last follow-up and complications(nonunion of fracture, femoral head necrosis) of two groups were compared. Results All patients were followed-up for 12-90 months(mean 39 months). The operation time and intraoperative bleeding of closed reduction group were lower than open group( P 0.05), the intraoperative fluoroscopy time and incidence of fracture nonunion had no statistically significant differences between two groups( P 0.05),the incidence of femoral head necrosis of open reduction group were lower than closed group( P 0.05), and Harris hip function score at the last follow-up was higher than closed group(P 0.05). Conclusion For displaced femoral neck fractures, open reduction and cannulated screw fixation has lower incidence of femoral head necrosis than the closed reduction.