Dynamic hip screw vs. proximal femur plate: Surgical outcomes in Pauwel's Type III femoral neck fractures

Abstract

Background: Femoral neck fractures, comprising 3.6% of all body fractures and 57% of hip fractures, are increasingly common among younger adults due to high-energy trauma. Pauwel’s type III fractures, characterized by a steep vertical angle, are particularly challenging, with high non-union rates and complications resulting from severe shear forces. Accurate measurement of Pauwel’s angle is essential for predicting outcomes. This study compares Dynamic Hip Screw (DHS) and Proximal Femur Plate (PFP) fixation methods in treating Pauwel’s type III fractures, focusing on intraoperative factors, outcomes, and complications. Patients and Methods: This prospective study conducted at Al-Kindy Teaching Hospital, Baghdad, included 16 adults with Pauwel’s type III fractures. Over one year (April 2023–2024), patients were divided into two groups: Group A (7 patients) received PFP fixation, while Group B (6 patients) underwent DHS fixation with an anti-rotation screw. Preoperative evaluations included routine exams, imaging, and anesthesiologist consultations. Surgery was performed under anesthesia, followed by rehabilitation and regular follow-ups. Data on surgery time, blood loss, and complications were collected and analyzed using SPSS, with a p-value