Treatment of Femoral Neck Fractures with a Sliding Compression Screw and Two Knowles Pins

Twenty-one patients with an average age of 65 years had displaced femoral neck fractures treated by a sliding compression screw and two Knowles pins. All patients had either Garden III or Garden IV fractures. One patient healed with a malunion and five developed symptomatic avascular necrosis; all of these patients required reconstructive surgery. There were no nonunions. The sliding compression screw with two Knowles pins gave a 100% rate of union, which was superior to most fixation methods. The incidence of avascular necrosis was 24%, the expected range for displaced femoral neck fractures.