Surgical management of fracture neck of femur using ccs in patients aged more than 50 years

Background: Fractures of the femoral neck are devastating injuries that most often affects the elderly and have a tremendous impact on the health care system and society in general. Patient who have presented with fracture neck of femur over the age of 60 but has been performing from a functional point of view as a younger individual have been excellent candidates for reduction with internal fixation. Methods: Thirty cases of fracture neck of femur in patients above the age of 50 years treated by closed reduction and internal fixation with cannulated cancellous screws in the Department of Orthopaedics at The Oxford Medical College and Hospital, Bangalore, were selected on the basis of purposive sampling method. The cases were followed up for 6 months and the short term functional results were analyzed by using Harris hip scoring. Results: Most of the patients were in the age group of 50-70. Majority (40%) of fractures were Garden type III on radiographs. 96.7% of them had minimal trauma. Of the 30 cases one patient died and one patient was lost for follow up. Thus the functional results were assessed in the remaining 28 patients. 85.7% of the hips were classified as having a satisfactory to excellent result and 14.3% of the patients had a poor result. No cases of AVN were observed, one case of non union was seen. Patients were made to walk with partial weight bearing after six weeks and were discharged within two weeks of surgery. Conclusion: Osteosynthesis with cannulated screws fixation provides the patient a healed fracture with a living femoral head that is always better and less invasive than a replacement in elderly patients; The mortality and morbidity rates are less with high rates of union, operative procedure is simple, economical, complications are less disabling and early functional results are satisfactory.