Comparing Therapeutic Outcomes of Dynamic Hip Screw and Multiple Cannulated Screws as Internal Fixation in Femoral Neck Fractures

Abstract

Background and purpose: Femoral neck fracture is associated with a high rate of side effects, especially in young people, who are usually affected by severe energy shocks. Results after injury depend on some factors, including displacement, fragility, bleeding rate, proper placement, and stable and strong fixation. The aim of this study was to compare dynamic hip screw (DHS) or multiple cannulated screws (MCS) in fractures of the femoral neck base. Materials and methods: In this cross-sectional study, 78 patients with femoral neck fracture were treated by internal fixation: MCS (n= 26) and DHS (n= 52) in Babol Shahid Beheshti Hospital, 2016-2018. Complications, including pain and lameness, infection, avascular necrosis (AVN), and nonunion were investigated in both groups. The visual analog scale (VAS) score and Harris Hip Score (HHS) were also compared between the two groups. Results: Mean ages of the patients in MCS group and DHS group were 54.19 ± 23.35 and 58.50 ± 21.06 years, respectively. In patients treated by MCS, infection, AVN, no welding, and pain and lameness were seen in 3, 2, 3, and 6 patients, respectively, while these complication were observed in 1, 1, 1, and 4 patients in the DHS group, respectively. The rate of complications were not found to be significantly different between the two group (P>0.05). The mean VAS score was significantly lower in the DHS group compared to that in the MCS group (P<0.05). The HHS scores were not significantly different between the two groups (P<0.05). Conclusion: According to this study, MCS is more appropriate in the treatment of femoral neck fractures due to less bleeding and shorter operation time.

Keywords

• femoral neck fracture
• internal fixator
• surgical complications
• visual analogue scale
• harris hip score