Functional Outcomes of Screw Fixation of the Fracture Head of the Femur: A Descriptive Study

Abstract

Introduction: Femoral head fractures are uncommon injuries where patient outcomes depend on immediate surgical workup and postoperative rehabilitation. This study aimed to evaluate the functional outcomes of patients treated by open reduction and internal fixation (ORIF) using the screw fixation technique for the fracture head of the femur. Materials and Methods: Fourteen patients with femoral head fractures were treated by ORIF using the screw fixation technique in the Department of Orthopedics at a tertiary care hospital in Coimbatore, India for a period of 2 years. They were followed up for a minimum of 1 year to assess postoperative fracture union, postoperative complications, and functional and radiological outcomes by using relevant scoring systems such as Harris Hip Score, Oxford Hip Score, and Thompson-Epstein Hip Score. Results: Femoral head fracture patients in the age group of 36 ± 12.5 years (M: F = 1.8:1), classified as per Pipkins and Thompson-Epstein system were operated using the ORIF technique and followed up for 3.3 ± 1.8 years; the mean range of motion at the operated hip joints achieved were flexion 115.5°, extension 24.4°, abduction 35.5°, adduction 26.5°, internal rotation 34.4°, and external rotation 36.6°. Harris’s hip score was excellent in 57%, good in 14%, fair in 7%, and poor in 21% of the subjects. Oxford’s hip scores were satisfactory in 93% of the subjects. Osteoarthritis (28.9%) and avascular necrosis (7.14%) were seen as complications. Conclusion: According to our Indian population and cost constraints prevailing, we extrapolate these results obtained to our community population and thereby recommend ORIF of fracture femoral head by the screw fixation technique and postoperative non-weight-bearing protocol as a safe treatment schedule.

Keywords

• femur
• fixation
• fracture
• functional
• screw