• J Orthop Trauma · Feb 2014

    Comparative Study

    Osteosynthesis of unstable intracapsular femoral neck fracture by dynamic locking plate or screw fixation: early results.

    • Ran Thein, Amir Herman, Paz Kedem, Aharon Chechik, and Nachshon Shazar.
    • *Department of Orthopedic Surgery; and †Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    • J Orthop Trauma. 2014 Feb 1;28(2):70-6.

    ObjectivesThe purpose of this study was to compare the postoperative radiologic and clinical outcomes of telescopic femur neck screws and small locking plate device (Targon FN) (group 1) with multiple cancellous screws (group 2) for displaced intracapsular femoral neck fractures.DesignComparison of a prospective collected data to a historical control group (retrospective).SettingOne community teaching hospital.PatientsSeventy-eight patients (group 1, 31; group 2, 47) underwent reduction and internal fixation of displaced intracapsular femoral neck fractures with either Targon FN device or multiple cancellous screws from March 2000 to July 2010. Their mean age was 53.7 years (SD: 16.4), and the mean follow-up period was 28.6 months.Main Outcome MeasuresTreatment failure was considered to be either a nonunion, osteonecrosis, or revision surgery of any type. Treatment was regarded as successful in patients who did not show failure and had at least 1-year follow-up.ResultsOne patient in group 1 (3.2%) and 22 (46.8%) in group 2 had a nonunion (P = 0.0001). Four (12.9%) group 1 patients and 16 (34.0%) group 2 patients underwent revision surgery (P = 0.036). Four (12.9%) patients in group 1 and 4 (8.5%) group 2 patients had osteonecrosis of the femoral head (P = 0.531). Multivariate logistic regression showed that internal fixation by the fixed-angle fixation device decreased the odds ratio for overall complication by a factor of 0.23, for example, by 77% (P = 0.018).ConclusionsPerforming internal fixation by a fixed-angle fixation device decreased nonunion rates and revision rates. It did not affect the rate of osteonecrosis.Level Of EvidenceTherapeutic level III. See instructions for authors for a complete description of levels of evidence.

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