Treatment of 92 cases of femoral neck fracture with hollow compression screw in Hunan Traditional Chinese Medicine Lei Qingliang (Shaoyang City Hospital of Traditional Chinese Medicine, Shaoyang 422001, China) Since the introduction of hollow compression screws in 1998 to treat femoral neck fractures, we have treated femurs by the end of 2001. 92 patients with neck fractures, after an average of 2 years of follow-up, have achieved satisfactory results, the report is as follows. 1 Clinical data of 92 patients, 61 males and 31 females, the oldest 74 years old, the youngest 36 years old, with an average of 50.5 years old. There were 27 cases of subtotal fractures, 36 cases of mid-neck fractures and 29 cases of basal fractures. According to the "Traditional Chinese Medicine Diagnosis and Treatment Efficacy Standard" promulgated by the State Administration of Traditional Chinese Medicine, there were 69 cases of outreach type and 23 cases of adduction type. 3 patients had femoral shaft fractures, and 5 patients had ipsilateral humeral shaft fractures. The time after the injury was as short as 1 hour, and the longest was 42 days, with an average of 2.5 days. The cause of injury was caused by trauma and no pathological fracture. The operation time after injury is up to 50 days, the shortest one day, and the average is 6 days. 2 treatment 2.1 surgical treatment patients admitted to the hospital after X-ray photos confirmed, they were treated separately. If there is no displacement of the fracture, that is, the lower limbs of the lower limbs and the super-knee long splint will fix the injured limb in the abduction neutral position, and prepare for the operation as soon as possible. If there is a shift, immediately perform a femoral epiphysis traction to be corrected as soon as possible after surgery. Surgical method: continuous epidural anesthesia, the patient lies supine on the operating bed, the limb abduction 30* internal rotation 15* fixation, such as bone traction patients need to continue to maintain traction, conventional hip disinfection, drape according to neck angle The femoral neck axis was marked with the femoral axis as the baseline, and a 1.5-gram needle was placed on the femoral neck axis. The position of the fracture and the femoral neck axis were accurately checked on the operating table. After everything is normal, three 1.5mm graduated K-wires are directly transcutaneously inserted into the upper and lower parts according to the position of the labeled K-wire. The needles of the three Kirschner wires are preferably 1~4cm below the femoral trochanter, and the spacing between each needle is about 1.5cm. Pay special attention to the anteversion angle of the femoral neck when entering the needle. After the puncture was completed, the X-ray film of the lateral side of the femoral neck was reviewed. According to the X-ray film, two K-wires with good position were selected and the remaining one was removed. Cut the skin, subcutaneous tissue, and periosteum along the two internal Kirschner wire lines. Select the length and diameter of the compression screw according to the size of the Kirschner wire and the size of the femoral neck, and insert the two screws into the Kirschner wire. , gradually screwed in, directly to the surface of the femoral head joint 0.5on. Re-examine the photo, adjust the depth of the screw according to the X-ray film. After all the satisfaction, rinse the wound, completely stop the bleeding, leave the drainage tube, suture the wound layer by layer, dress the dressing, and deliver it to the ward. In patients with preoperative fracture without displacement, 3~4kg of the patient was used to pull the affected limb in the abduction neutral position. The displaced patient will maintain the bone traction in the abduction neutral position, the weight is about 5~6kg, and the traction time is about 15~ 21 days. After the operation with antibiotics and traditional Chinese medicine treatment, within 3 months do not cross-legged, not lying on the side, no weight. 2.2 Chinese medicine treatment All patients were treated according to the syndrome of three stages of fracture, combined with the use of Chinese medicine for the treatment of fractures in the preparation room of our hospital, early use of Huoxue Zhitong mixture, medium-term use of Zhuyu Jiegu capsule, and late use Yishen Zhuanggu capsule. 3 Treatment results Among the 92 patients, 86 patients were treated with this method of closure and nailing. Six patients were unsatisfactory due to a one-week reduction after bone traction. The reduction was performed under direct vision and the compression screw was fixed. After 6 to 44 months of follow-up, an average of 23 months, a total of 87 cases of bone healing, the rate of healing was 94.6%. Among them, patients with abduction and neck and basal fractures all healed. Of the 5 nonunion patients, 4 were under the head and the lower abduction fracture, and 1 was a subtotal ablation fracture. There were 5 cases of femoral head necrosis, the necrosis rate was 6.5%, the average necrosis time was 24 months, the longest was 40 months, and the shortest was 18 months (since some patients had shorter follow-up time). According to the "Diagnostic and Efficacy Standards for TCM Diseases". Chinese Journal of Otorhinolaryngology, 1994 issue 丨J China Journal of Integrated Traditional Chinese and Western Medicine,19899 (2): This group of cases did not see an allergic reaction. There was 1 case of numbness in the lower limb of the affected side after the injection, and the muscle was weak, but recovered after two weeks. About 70% of patients have increased back pain after injection. Lumbar disc herniation compresses the spinal cord or nerve roots and causes a series of clinical manifestations such as low back pain and sciatica. Other conservative therapies, such as closure, drug application, traction, etc., may relieve or heal the symptoms, but not the prominent discs. Collagenase has a specific and specific degradation effect on collagen, so that the protrusions are hydrolyzed and decompressed to achieve therapeutic purposes. The traditional Chinese medicine Mahuang Fuzi Xixin Decoction acts to clear the meridians and relieve symptoms. In combination with collagenase injection, both the symptoms and the root causes. Mahuang Fuzi Xixin Decoction is the main prescription for treating the sun and Shaoyin disease in Treatise on Febrile Diseases. The author found in the clinic that the symptomatic part of lumbar disc herniation is similar to the meridian of the foot sun bladder and the foot Shaoyin kidney, so the treatment is effective. In short, the use of collagenase intervertebral disc injection combined with Chinese medicine Mahuang Fuzi Xixin Decoction treatment of this disease, not only can dissolve the prominent disc, but also dredge meridians, both the symptoms and root causes. Compared with the control group, the clinical effect was obvious. (Continued from page 498) 4 Discussion Femoral neck fractures are common fractures in middle-aged and elderly patients, and the incidence of femoral head necrosis and fracture nonunion is relatively high. The treatment method can be applied to patients with various types of femoral neck fractures. In the case of satisfactory closed reduction, the operation is simple, the trauma caused to the patient is small, and it is easy for the elderly patients to accept. The compression screw only needs to be fixed twice, the bone destruction of the femoral neck is less, and the two ends can be in close contact. The anti-loading and anti-rotation ability is strong, so the prognosis is good, so the therapy can be widely promoted in the primary hospital. . Fine Specialty Chemicals, Textile Chemicals, Speciality Chemicals Dynasty Chemicals (NingBo) Co., Ltd. , https://www.dychemco.com
Treatment of 92 cases of femoral neck fracture with hollow compression screw in Hunan Traditional Chinese Medicine Lei Qingliang (Shaoyang City Hospital of Traditional Chinese Medicine, Shaoyang 422001, China) Since the introduction of hollow compression screws in 1998 to treat femoral neck fractures, we have treated femurs by the end of 2001. 92 patients with neck fracture, after an average of 2