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Multicenter Study
. 2024 Jan;45(1):54-59.
doi: 10.15537/smj.2024.45.1.20230684.

Treatment of non-displaced intracapsular femoral neck fractures with dynamic hip and cannulated screws resulting in avascular necrosis: A comparative study of complications

Hashem A Bukhary  1 , Fahd I Aljuaid  1 , Khalid M Alhomayani  1 , Abdulelah A Saati  1 , Amaal M Aldosari  1 , Wateen A Hammadi  1 , Hamed S Qutbuddeen  1 , Abdulhafiz A Wazuddin  1 , Haneen A Hammadi  1 , Amjad M Jawhari  1
Affiliations
Multicenter Study

Treatment of non-displaced intracapsular femoral neck fractures with dynamic hip and cannulated screws resulting in avascular necrosis: A comparative study of complications

Hashem A Bukhary et al. Saudi Med J. 2024 Jan.

Abstract

Objectives: To compare the complications associated with cannulated hip screws (CHS) and dynamic hip screws (DHS) techniques.

Methods: In this multicenter retrospective chart study, we reviewed the records and data of all patients operated upon by DHS or CHS for treatment of Garden type I and type II intracapsular non-displaced femoral neck fracture from January 2017 to December 2022. Patients with incomplete files or follow-ups of less than one year were excluded from the study.

Results: The study enrolled 85 patients, 35 males, and 50 females, with a mean age of 72±5.4 for males and 70.6±7.6 for females. A total of 44 patients were operated upon with DHS, and 41 patients with CHS. The mortality rate of DHS was 15.9% and was 17.1% in the CHS group (p>0.05). Non-union was recorded in 4.5% of the DHS group and 4.9% of CHS patients (p>0.05). Avascular necrosis (AVN) was significantly higher in DHS (9.1%) than in CHS (4.9%, p<0.05). A revision was required in 15.9% of DHS patients and 14.6% of CHS patients (p>0.05).

Conclusion: This study found that DHS was superior to CHS in AVN rate. However, there was no significant difference between both methods regarding mortality, revision, and non-union.

Keywords: complications; femoral neck fracture; internal fixation devices.

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Figures

Figure 1
Figure 1
- Intraoperative images displaying right femoral neck fractures fixed by cannulated hip screws. A) Anteroposterior and B) lateral views.
Figure 2
Figure 2
- Intraoperative images displaying left femoral neck fractures fixed by dynamic hip screws with anti-rotational screws. A) Anteroposterior and B) lateral views.
Figure 3
Figure 3
- Postoperative images display a fracture complicated by avascular necrosis of the right femur head. A) Coronal CT; B) an anteroposterior x-ray; and C) an axial MRI views of the right hip.
Figure 4
Figure 4
- A fixed fractured neck of the femur is complicated by non-union and implant failure on an anteroposterior x-ray view.
See this image and copyright information in PMC

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