Cannulated cancellous screws fixation in intracapsular fracture neck femur: a study with an emphasis on result of osteosynthesis

Background: Fracture neck of femur has always presented a great challenge to the orthopaedic surgeons. It is rightly called as “unsolved fracture” as far as treatment and results are concerned. Results generally depend upon time period elapsed from fracture to surgery, adequacy of reduction and fixation. Fixation with cannulated cancellous screw is usually adequate for femoral neck fractures. The aim of the study was to analyse the results of treatment of fracture neck of femur with cannulated cancellous screw fixation and to compare the results with others in the literature using the same modality. Methods: 25 patients with intra capsular neck of femur fracture were followed for a period of two years post-surgery and their functional outcome was assessed based upon harris hip scoring system.Results: According to harris hip scoring system, we had excellent results in 72% cases, good in 16% cases, fair in 8% and poor in 4%. One patient went into non-union and two developed avascular necrosis of femoral head.Conclusions: Management of intracapsular fracture neck of femur with cannulated cancellous screw fixation is a very good method of treatment being a surgically easy procedure. Use of multiple cannulated cancellous screw have a compression effect at the fracture site. It also avoids re displacement and rotation.

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Fracture neck of femur treated with hemiarthroplasty and cannulated cancellous screw fixation: a comparative study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172885 ◽

2017 ◽

Vol 3 (4) ◽

pp. 849

Author(s):

S. K. Rai ◽

Rohit Vikas ◽

Vyom Sharma ◽

S. S. Wani ◽

Rohit Varma

Keyword(s):

Fracture Fixation ◽

Screw Fixation ◽

Type I ◽

Age Group ◽

Cancellous Screw ◽

Neck Of Femur ◽

Non Union ◽

Fracture Neck Of Femur ◽

Group A ◽

Group B

Background: Intracapsular fracture neck of femur has always presented great challenges to every Orthopaedic surgeons and it is remain a mystery whether to fix or to replace the fracture in the elderly. The aim of the study was to analyze the functional outcome of two widely used and accepted modalities of treatment in the age group 57-75 years, in Garden’s type I and II fractures, namely (a) cannulated cancellous screw fixation(internal fixation) and (b) modular bipolar prosthetic replacement of the femoral head (hemiarthroplasty).Methods: The total 110 patients were including in the study from age groups 57-75 (mean age 66). The Garden classification of fracture neck of femur was used to evaluate the displacement of femoral neck fractures. Only grade 1 and 2 was included in the study. 55 patients were included in each group A and B. Osteosynthesis (fracture fixation) was carried out by closed reduction and insertion of cannulated cancellous screw and in other group hemiarthroplasty was done.Results: In group A 55 patient with fracture neck of femur was treated by osteosynthesis i.e. fixation using 02 or 03 cannulated cancellous screw and in group B, 55 patients with fracture neck of femur was treated by modular bipolar replacement hemiarthroplasty. In Group A out of 55, 41 patients union was achieved between 08 to 14 months (mean 11.5 month), 09 patients developed non-union even after 16 months and 05 patients develop collapse of head with AVN with shortening at end of 02 year, however in Group B out of 55 patients 51 patients started walking after 2nd postoperative days, 02 patients developed infection, and 02 patients developed posterior dislocation.Conclusions: The fracture fixation may be tempting for fracture neck femur in age group 57-75 especially of Garden Type I but internal fixation put risk of non-union and AVN and second surgery may be required after few months or years if patients survive. Based on results in our study we therefore can conclude that in Garden Type I and II femur neck fractures in the patients between 57-75 years of age, hemiarthroplasty is the better modality of treatment.

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INTRACAPSULAR FRACTURE OF NECK OF FEMUR (IC#NF) - OSTEOSYNTHESIS BY CANNULATED CANCELLOUS SCREW FIXATION

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2016/859 ◽

2016 ◽

Vol 3 (74) ◽

pp. 4021-4024

Author(s):

Lokanadha Rao L ◽

Satish Kumar Dake ◽

Surya Vardhan K ◽

Vikas Rathod ◽

Sivani V ◽

...

Keyword(s):

Screw Fixation ◽

Cancellous Screw ◽

Intracapsular Fracture ◽

Neck Of Femur

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WITH REGARDS TO THE CLINICO-FUNCTIONAL OUTCOMES, IN BETWEEN FQPP OR BDSF TECHNIQUE, WHICH IS SUPERIOR, AS A CANCELLOUS SCREW FIXATION OPTION, FOR FRACTURE NECK OF FEMUR.

10.36106/ijsr/6104584 ◽

2021 ◽

pp. 53-56

Author(s):

Vijayaselvan S ◽

Venkatachalam K

Keyword(s):

Femoral Head ◽

Screw Fixation ◽

Harris Hip Score ◽

Cancellous Screw ◽

Neck Of Femur ◽

Double Support ◽

Fracture Neck Of Femur ◽

Classi Cation ◽

Poor Outcomes ◽

Four Quadrant

Fracture Neck of Femur are common and one among the most challenging Orthopaedic trauma cases. Many a factors like age, time elapsed after occurrence of injury, presence of other musculo-skeletal trauma and presence of other co-morbid conditions, are all to be taken into account, before embarking on any surgical intervention. Given the precarious blood supply of the femoral head, AVN of the femoral head is a signicant complication in the displaced fractures. Among the various classication systems available, the Garden classication is still in vogue, as highlighted by Guyton J.L et al; (1). The purpose of this prospective study, is to establish the superiority or otherwise of the 'Four Quadrant Peripheral Parallel (FQPP) Screw Fixation” technique, over the “Biplanar Double Support Screw Fixation (BDSF)” technique, when opting for multiple percutaneous cancellous screw xation, for fracture neck of femur. The age group in our study included patients from 26 years to 55 years and had a total of 18 patients, who were recruited in between March 2018 to February 2020. Of these 18 patients, 9 patients were treated by the FQPP technique and another 9 patients by the BDSF technique. All cases were followed-up for at least 1 year (range: 12 to 35 months, mean 18 months). Evaluation was done by Harris Hip Score (HHS) (2). In the FQPP group, 55.56% (n=5) patients had good to excellent results, 22.22% (n=2) patients had fair and 22.22% (n=2) patients had poor outcomes. In the BDSF group 66.67% (n=6) patients had good to excellent results, 22.22% (n=2) patients had fair and 11.11% (n=1) patient had poor outcome. Thus, the results were only just marginally better for the BDSF group, in comparison to the FQPP group and hence, no substantial deductions could be made favoring the superiority of one xation type over the other.

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PAUWEL'S OSTEOTOMY AND OSEOSYNTHESIS

The Professional Medical Journal ◽

10.29309/tpmj/2007.14.01.3631 ◽

2007 ◽

Vol 14 (01) ◽

pp. 89-96

Author(s):

MUHAMMAD ASGHAR ◽

MUKHTAR AHMED TARIQ ◽

MUHAMMAD SHAFEE

Keyword(s):

High Energy ◽

Fracture Site ◽

Greater Trochanter ◽

Neck Of Femur ◽

Non Union ◽

Fracture Neck Of Femur ◽

Younger Age ◽

Serious Injuries ◽

Trauma In Elderly

Introduction:- Fracture neck of femur is one of serious injuries encountered in orthopaedic trauma management. It can result from trivial trauma in elderly but are usually the result of high-energy trauma in the younger age group. Objective- To evaluate the results of Pauwel's osteotomy and oseosynthesis in patients with non union of femoral neck fractures. Setting Orthopaedic Unit, Nishtar Hospital, Multan. Duration 1989-1998. Material and methods Sample size 30 patients. Results: 30 cases of neglected fracture neck of femur treated. 5 patients were treated first with traction where greater trochanter migrated a way up to bring it down to the proper level. Then osteotomy was done. In 25 cases Pauwels' osteotomy was primarily done and fixed with 120 degree osteotomy plate. Follow up period ranged from 7 months to 2 and half years. Patients were assessed for reduction of the fracture site in according to alignment index by Garden for union of the fracture and range of mobility and pain relief in follow up period. Conclusion:- This is a reliable method of dealing with nonunion of the fracture neck of the femur in young adults.

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