Key result
Dynamic hip screw fixation resulted in 100% good functional outcomes and a 0% rate of avascular necrosis, compared to 46% good outcomes and a 12.5% avascular necrosis rate with cannulated cancellous screws.
Why the study?
The multitude of available implants and techniques for intracapsular fracture neck femur reflects the inadequacy of current treatment methods.
Do cannulated cancellous screws compared to dynamic hip screws improve functional outcomes in productive age patients with femoral neck fractures?
Observational (n=97)
No
Do cannulated cancellous screws compared to dynamic hip screws improve functional outcomes in productive age patients with femoral neck fractures?
Absolute Event Rate: 100% vs 46%
In young adult patients with femoral neck fractures, DHS may be a more reliable implant than CCS for surgeons lacking specific expertise with CCS.
DHS may be preferable to CCS for young femoral neck fracture patients; leaves open confirmation in randomized trials.
Background: Since intracapsular fracture neck femur was recognized by Ambrose Pare almost 4 centuries back, the management of intracapsular neck femur fracture has undergone many changes. The multitude of various implants designed and techniques available for its treatment themselves indicate the inadequacy of the various methods of treatment. Objective was to compare cannulated cancellous screws (CCS) versus dynamic hip screw (DHS) in femoral neck fractures in productive age group. Methods: This observational study with both prospective and retrospective data analysis of patients operated by different surgeons in same hospital setup has been conducted from March, 2018 to February, 2020 at the department of Orthopedics, Government Medical College (GMC), Jammu. 105 cases satisfying the inclusion criteria admitted in GMC Jammu were included clinically and radiologically. Total number of patients included in the study was 97 patients as 8 patients were lost to follow-up. Functional outcome was evaluated by using Harris hip scoring. Results: In our study 8 CCS cases were lost to follow up. Total 97 of cases were followed up till one year both radiologically and clinically after a given time intervals and final assessment done on the basis of Harris hip score. Among 97 cases 71 were males most of them in age group of 41-45 years and 26 were females with 46-50 years age group predominance. 47.42% fractures were classified as type III in garden’s staging. Conclusions: DHS is a better implant than CCS in hands of doctors who lack of expertise and precision i.e. required for CCS in fracture neck femur in young adult patients.
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Arfee et al. (2020) conducted an observational in Femoral neck fractures (n=97). Dynamic hip screw (DHS) vs. Cannulated cancellous screws (CCS) was evaluated on Good functional outcome. Dynamic hip screw fixation resulted in 100% good functional outcomes and a 0% rate of avascular necrosis, compared to 46% good outcomes and a 12.5% avascular necrosis rate with cannulated cancellous screws.
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