Comparison of dynamic hip screw and antirotation screw with cannulated screw in the treatment of transcervical collum femoris fractures

Abstract

Objectives: This study aims to compare the results of internal fixation with dynamic hip screw (DHS)/antirotation screw and conventional cannulated screw (CS) for femoral neck fracture.

Patients and methods: This retrospective study included a total of 78 patients (57 males, 21 females) with collum femoris fractures treated with internal fixation between January 2015 and January 2019. Group 1 comprised 41 patients with a mean age of 45.7 years (range, 19 to 62 years) treated with DHSs/antirotation screws, while group 2 comprised 37 patients with a mean age of 41.9 years (range, 17 to 75 years) treated with CSs. The patients were evaluated for union, avascular necrosis (AVN), femoral neck shortness, operation time, duration of fluoroscopy exposure, and functional outcomes.

Results: Age, gender, and Garden classification stages were similar in both groups. No significant difference was found between the groups in respect of AVN and non-union rates. The non-union rate was 12.2% in group 1 and 21.6% in group 2 (p>0.05). The duration of fluoroscopy exposure was statistically significantly higher in group 2 (p=0.001) and the operation time was statistically significantly longer in group 1 (p=0.001). In group 2, femoral neck shortness stature was significantly higher (p=0.007). At the final follow-up examination, the Harris hip score was statistically significantly higher in group 1 (p=0.04).

Conclusion: Dynamic hip screw/antirotation screw was a more relevant treatment method for transcervical femoral neck fractures compared to CS with more favorable functional outcomes and less fluoroscopy exposure.

Figure 1. A 56-year-old male patient, right hip, operated at 22 hours after trauma. (a) Preoperative anteroposterior graphy. (b) Preoperative lateral graphy. (c) Postoperative anteroposterior graphy at six months. (d) Postoperative lateral graphy at six months.

Figure 2. A 49-year-old male patient, right hip, operated at 14 hours after trauma. (a) Preoperative anteroposterior graphy. (b) Preoperative lateral graphy. (c) Postoperative anteroposterior graphy at six months. (d) Postoperative lateral graphy at six months.