A comparative study between multiple cannulated screws and dynamic hip screw for fixation of femoral neck fracture in adults

Abstract

Purpose: In younger adults with fractures of the femoral neck, anatomic reduction is compulsory and maintaining the reduction is crucial. Both cannulated screws and dynamic hip screw (DHS) have the capacity of compression in the fracture site but the strength for keeping reduction is not the same. The aim of this study was to compare the results with fixations of the femoral neck fractures with cannulated screws versus dynamic hip screw.

Methods: This is a randomized clinical trial study on 58 cases with a minimum of one year follow-up. Leg length discrepancy, Harris Hip Score, infection, avascular necrosis of femoral head, and union of the fracture site were evaluated.

Results: There were two failures in the first trimester in the cannulated screw group and three more failures in the second and third trimesters in this group. In the DHS group, there was no reduction and fixation failure in the follow-up period. There was no fixation failure (0 %) in Group B (DHS) but there were five fixation failures (18 %) in Group A (screw), and there is significant difference between the groups (p < 0.001). The rate of avascular necrosis was the same in both groups.

Conclusions: It seems to us that in our practice the fixation of femoral neck fracture in young adults with the DHS is a better option compared with the osteosynthsis with multiple cannulated screws.

Keywords: Cannulated screw; Dynamic hip screw; Fracture; Neck of femur.