Key result
Dynamic hip screws yielded excellent clinical outcomes in 75% of patients compared to 56.2% with multiple cancellous cannulated screws for femur neck fractures, with similar complication rates.
Why the study?
Does dynamic hip screws compared to multiple cannulated cancellous screws improve outcomes in patients with femur neck fracture?
RCT (n=32)
Randomized
No
Does dynamic hip screws compared to multiple cannulated cancellous screws improve outcomes in patients with femur neck fracture?
Absolute Event Rate: 75% vs 56.2%
DHS is associated with longer operative time and greater blood loss compared to MCCS, but yields excellent functional outcomes in the majority of patients.
DHS preferred over cannulated screws for femur neck fractures given superior outcomes; extends RCT evidence on fixation choice.
Background: Dynamic hip screws (DHS) and multiple cannulated cancellous screws (MCCS) are commonly used in anatomic reduction of femur neck fractures. However, there is limited information on the complications of various fixation methods. Objective: To assess the outcome of two different modalities of femur neck fracture fixation. Methodology: This prospective, randomized, comparative interventional study included 32 subjects with recent trauma. Patients were randomized to DHS and MCCS treatment groups (16 patients each). Post-surgical radiographs were obtained and clinical evaluation for deformities was performed using the Harris hip score (HHS). The duration of surgery, average blood loss, and complications were noted and assessed. Chi-square test was used to check the association between attributes. Two-sample t-test was employed to compare the mean between two groups. P≤0.05 indicated statistical significance. Results: A significant difference (p<0.001) between the 2 groups was noted with regard to patients’ age. The median operative time for DHS and MCCS groups was 75 mins (range 60-90 mins) and 60 mins (range 50-70 mins), respectively. Average blood loss was more in DHS (200 mL) than in MCCS (120 mL) group. Majority of the patients (75%) in the DHS group showed excellent HHS results.
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Patil et al. (2022) conducted an RCT in Femur neck fracture (n=32). Dynamic hip screws (DHS) vs. Multiple cancellous cannulated screws (MCCS) was evaluated on Excellent clinical outcome (Harris hip score 90-100). Dynamic hip screws yielded excellent clinical outcomes in 75% of patients compared to 56.2% with multiple cancellous cannulated screws for femur neck fractures, with similar complication rates.
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