Reduction assisted by a double-needle repositor for femoral neck fractures of Garden types III-IV

Objective To compare the efficacy between reduction assisted by a double-needle repositor and manual reduction in the treatment of femoral neck fractures of Garden types Ⅲ-Ⅳ. Methods From May 2015 to October 2017, 67 patients with femoral neck fracture of Garden type Ⅲ or Ⅳ were treated by hollow screw fixation at Department of Orthopaedics, The Second Affiliated Hospital to Shanxi Medical University. They were divided into 2 groups according to the different reduction methods. The reduction was assisted by a double-needle repositor in 37 cases (group A); they were 21 males and 16 females with an age of 46.2±8.1 years and there were 13 cases of Garden type Ⅲ and 24 cases of Garden type Ⅳ. The reduction was conducted manually in another 30 cases (group B); they were 18 males and 12 females with an age of 48.8±9.1 years and there were 13 cases of Garden type Ⅲ and 17 cases of Garden type Ⅳ. The 2 groups were compared in terms of reduction time, anatomical reduction rate, operation time, intraoperative bleeding volume, fracture healing time, postoperative complications and Harris hip scores at the last follow-up. Results There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible(P>0.05). All the 67 patients were followed up for 20 to 30 months (average, 24 months). The anatomic reduction rate in group A [94.6% (35/37)] was significantly higher than that in group B [83.3% (25/30)]; the reduction time, operation time and fracture healing time in group A (33.2±4.6 min, 70.2±5.0 min and 4.6±0.7 months) were significantly shorter than those in group B (45.8±8.6 min, 90.6±9.2 min and 5.6±0.6 months); the Harris hip scores at the last follow-up in group A (84.3±8.6 points) were significantly higher than in group B (81.2±7.8 points) (all P 0.05). Conclusion Reduction assisted by a double-needle repositor is fine for femoral neck fractures of Garden types of Ⅲ-Ⅳ, because it has advantages of limited invasion, simplicity, a high rate of anatomical reduction, quick reduction and good functional recovery. Key words: Femoral neck fractures; Fracture fixation, internal; Bone nails; Reduction; Double-needle repositor