There are open reduction and internal fixation of the pedicle screw and bone traction therapy, but they all have some shortcomings, such as open reduction and open joint capsule, large destruction surface, severe damage to the blood supply system. We have used the broken screw produced by Zhangjiagang Medical Equipment Factory in 1996 to treat the femoral neck fracture, and achieved satisfactory results. The current report 1 data and methods 1.1 data in this group of 58 cases, 62 femoral neck fractures, including 38 males, There were 20 females; 43 left and 19 right; the average age was 52 years old and 2872 years old; 8 linear fractures of the base of the femoral neck and 54 total fractures of the base of the neck. The line is now in the form of 56 on-chip type, 6 outreach type, the ratio is about 9.41.0. 1.2 Surgical method Epidural anesthesia under the patient, under the arm under the supine, the affected side of the buttocks 1215 high, 1 assistant holding the affected side of the ankle, straight position with a slight pull internal rotation, first with the root bone round The needle temporarily fixes the fracture end and at the same time plays a positioning role. The direction of the round needle should be considered in consideration of the neck anteversion angle. Since the height is 1215 before the operation, the neck angle can be accurately grasped at the horizontal position during operation. Pass through the fracture end. Rotate the 0-arm and observe the lateral needle insertion. If you are satisfied, make 23 long small incisions in turn, and use the bone drill to drill 34 unequal-length broken screws along the positioning needle to drill the fractured end arm. Active hip joint, if the fracture end is aligned and the line is stable, pull out the round needle, break the screw, and the operation is completed. The operation time is 15 min. After the operation, the CPM machine can be used for joint function practice. After 1 week, the joint function is performed. The line was discharged. 1.3 complications 1 case due to senile osteoporosis, unsatisfactory fixation, changed to total hip replacement, 1 patient showed a sterile necrosis of the femoral head at 1 year after treatment. 2 Results 58 cases of 62 femoral neck fractures, followed up for 13 years, an average of 2 years and 2 months. According to the fracture healing standard, 55 cases of 59 femoral neck fractures were healed in one stage. One case was changed to total hip replacement. One case died of other diseases 1 year and 2 months after operation. One patient had a recurrent episode of aseptic necrosis of the femoral head, but the fracture site had healed. 3 Discussion 3.1 Surgical methods and selection of internal fixations Femoral neck fractures are often found in the elderly, with a variety of internal collection, is an unstable fracture, and a long healing time, so the use of surgical treatment, such as the open reduction of the wing spike goose The treatment of head nail cancellous bone screw fixation has good curative effect, but the implementation of large-scale surgery increases the risk. The patient has a long time of pain, high cost and high probability of complications. For example, under the perspective of Kleb's needle round needle fixation Due to the smooth edge of the internal fixation and the osteoporosis in the elderly, the binding force of the bone to the needle wall is reduced. The needle is often slipped before the fracture is healed, and it is outwardly expelled or even worn in the abdominal cavity, and has to be healed in the fracture. The internal fixation is removed before, resulting in treatment failure, and the fixation does not have any pressurization effect, which reduces the stability of the fracture end. The front end of the broken screw is a cancellous bone thread, and the rear end has a 1 1 diameter hex nut. The cutting type advances when the nail is inserted, which reduces the deformation of the trabecular bone and the increase of the intraosseous pressure, which is beneficial to the regeneration of the blood in the femoral head. And bone repair. The hex nut is placed outside the cortical bone, and the bone bite at the front end can be close to the proximal fracture, so that 34 nails can fully press and fix the fracture site, which is firm and reliable. 4, the broken screw is in the hex nut. The rear has a fixed length handle that can be used on ordinary bone drills without special equipment. 3.2 type arm and 01 machine application Closed reset under C-arm monitoring, making the operation procedure simple, IIT shortened; postoperative application of CPM machine to promote local blood circulation, promote early healing of fracture, reduce postoperative complications, reduce femoral head The chance of aseptic necrosis lays the foundation for early rehabilitation of the patient.
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