Cannulated cancellous screws fixation in intracapsular fracture neck femur: a study with an emphasis on result of osteosynthesis
Keywords:Intra capsular fracture neck of femur, Cannulated cancelous screw, Osteosynthesis, Osteonecrosis
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.
Pare A. The work of that famous chirurgion A. Pare. Translated out of Latin and compared with French by Tho. Johnson, book XV London, T. Cotes and R. Young, 1634.
Dickson JA. The unsolved fracture. J Bone Joint Surg. 1953;35:805-22.
Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg. 1961;43(4):647-63.
Garden RS. Malreduction and avascular necrosis in subcapital fractures of the femur. J Bone Joint Surg. 1971;53(2):183-97.
Garden RS. Reduction and fixation of subcapital fractures of the femur. Orthop Clin North Am. 1974;5:683-712.
Mcelvenny RT. The importance of the lateral x-ray film in treating intracapsular fracture of the femur. Am J Orthop. 1962;212-5.
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty an end-result study using a new method of result evaluation. J. Bone and Joint Surg. 1969;51:737-55.
Eiskjaer, S, Ostgard SE. Risk factors influencing mortality after bipolar hemiarthroplasty in the treatment of fracture of the femoral neck. Clin Orthop. 1991;270:295-300.
Garcia A. Displaced intracapsular fractures of the neck of the femur mortality and morbidity. J Trauma. 1961;1:128-32.
Dorr LD, Glousman R, Hoy AL, Vanis R,Chandler R. Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. J Arthroplasty. 1986;1:21-8.
Drake JK, Meyers MH. Intracapsular pressure and hemarthrosis following femoral neck fractures. Clin Orthop. 1984;182:172-6.
Asnis SE, Wanek SL. Intracapsular fractures of femoral neck: Results of cannulated cancellous screw fixation. J Bone Joint Surg. 1994;76:1793-1803.
Sankaran B. Osteoporosis clinical, radiological, histological, assessment and an experimental study. 2000.
Skinner PW, Powles D. Compression screw fixation for displaced subcapital fractures of the femur: success or failure? J Bone Joint Surg. 1986;68:79-87.
Hogh J, Jensen J, Lauritzen J. Dislocated femoral neck fractures: follow-up study of 98 cases treated by multiple AO cancellous screws. Acta orthop. Scan. 1982;53:245-9.
Baker GI, Barrick EF. Deyerle treatment for femoral neck fractures. J Bone Joint Surg. 1978;60:269-71.
Wood DJ, Gale DW, Stevens J. The Asnis guided system for fixation of subcapital femoral fractures. Injury. 1991;22:190-2.
Springer ER, Lachiewicz PF, Gilbert JA. Internal fixation of femoral neck fractures a comparative biomechanical study of knowles pins and 6.5-mm cancellous screws. Clin Orthop. 1991;267:85-92.
Catto M. A histological study of avascular necrosis of the femoral head after transcervical fracture. J Bone Joint Surg. 1965;47(4):749-76.
Stromqvist B, Hansson LI, Ljung P, Ohlin P, Roos H. Pre-operative and postoperative scintimetry after femoral neck fracture. J Bone Joint Surg. 1984;66(1):49-54.