A controlled clinical trial on two minimally invasive methods for the treatment of femoral neck fracture

Objective:To compare therapeutic effects between external fixation apparatus and cannulated lag screws internal fixation for the treatment of femoral neck fractures,so as to find better method for treating it.Methods:Among 63 patients treated with external fixation of three locked pin compressive apparatus,24 patients were male and 39 patients were female,ranging in age from 55 to 89 years,with an average of 64.5±3.2 years.According to Garden classification,Type Ⅰ fracture occurred in 2 patients,Type Ⅱ in 15 patients,Type Ⅲ in 38 patients and Type Ⅳ in 8 patients.In the internal fixation group with cannulated lag screws,there were also 63 patients(29 males and 34 females,ranging in age from 45 to 76 years,with an average of 62.2±2.9 years.According to Garden classification,Type Ⅰ fracture occurred in 4 patients,Type Ⅱ in 24 patients,Type Ⅲ in 28 patients and Type Ⅳ in 7 patients.The therapeutic effects of the two groups were compared.Results:One hundred and twenty-four patients were followed up and 2 patients were dead.During the follow-up period,115 patients were healed and 10 patients had femoral head necrosis.In external fixation group,58 patients were healed,4 patients had femoral head necrosis and 1 patient was dead;while in internal fixation group,57 patients were healed,6 patients had femoral head necrosis and 1 patient was dead.According to Harris functional evaluation criteria,in the external fixation group 24 patients obtained excellent results,26 good,8 fair,and 4 bad,the excellent and good rate was 80.65%;in the internal fixation group,above numbers were 23,27,6,6 and 80.65% respectively.The results of Harrsi score:the average score of external fixation group was 80.40±1.21 and the internal fixation group was 79.14±1.47.The average score of the groups had no statistical differences(P0.05).Conclusion:The therapeutic effects of internal and external fixation method for the treatment of femoral neck fractures has no obvious differences,but the external fixation posses advantages such as minimal wound,lower cost and early leaving the bed and moving,and the internal fixation has expensive cost,long time in bed and secondary surgery of taking out internal fixation pins.