Comparison of radiological and functional outcome in patients with femoral neck fracture operated with dynamic hip screw versus multiple cannulated screws

Abstract

Introduction: Intracapsular fractures of neck femur have always presented a great challenge to orthopaedics surgeons and remain in many ways the unsolved fracture as far as treatment and results are concerned especially in younger population. Intracapsular fracture neck of femur is regarded as an orthopaedic emergency and needs to be reduced with rigid internal fixation which is believed to improve the circulation of femoral head and prevent the nonunion and avascular necrosis. In our country sliding hip screw is not commonly used for intracapsular neck femur fracture fixation as compared to cannulated screw fixation, we have undertaken this comparative study to assess the outcome of both fixation modalities as well as factors influencing the results of these fixations in our population. Materials and Methods: This is a prospective randomized study conducted at tertiary care hospital in department of Orthopaedics consists of 62 patients which were randomized into 2 groups. Group A(n=31) patients were operated with 3 cannulated cancellous screws and Group B(n=31) patients were operated with Dynamic hip screw. Results: We have found DHS not only to be to be more stable but also allows better compression across the fracture, allowing early mobilization and early union. There was no complication of non-union in patients managed with DHS while 3 patients managed with CC screw progressed to non-union. Average time for union in our study was 14 weeks for patients managed with DHS while it was 18 weeks for patients managed with CC screw. Conclusion: We recommend use of DHS with derotation screw for managing all the patients of fracture neck femur i/v/o early mobilization, early union and reduced risk of non-union.