Clinical research of open reduction and internal fixation with cannulated screws combined with vascularized bone graft for femoral neck fractures

Objective To investigate the clinical effect of open reduction and internal fixation with cannulated screws combined with vascularized bone graft for femoral neck fractures. Methods Ninety seven cases of femoral neck fracture were treated by open reduction and internal fixation with cannulated screws(control group, 45 cases) or open reduction and internal fixation with cannulated screws combined with vascularized bone graft(flap treatment group, 52 cases). All the patients were evaluated by Harris score after operation. Results Ninety two cases(42 cases of control group and 50 cases of flap treatment group) were followed up for 1 to 20 years, with 7.28 years on average. At 6, 12 months after surgery and the last follow up, the Harris score of flap treatment group were all higher than control group, there's significant difference(P 0.05). In the control group nonunion incidence rate was 9.5%, incidence of avascular necrosis of femoral head was 14.3%; incidence of avascular necrosis of femoral head of flap treatment group was 2%, with no nonunion. Compared with the control group, the incidence of nonuion and avascular necrosis of femoral head was lower(P 0.05). Conclusion The cannulated compression screw in combination with bone graft is an optimal treatment for femoral neck fracture with low nonunion rate and a low incidence of bone necrosis and better long-term effect.