COMPARING THE RADIOLOGICAL AND FUNCTIONAL RESULTS OF PATIENTS WHO HAD NUMEROUS CANNULATED SCREWS VERSUS DYNAMIC HIP SCREWS FOR FEMUR NECK FRACTURES: A RANDOMIZED CLINICAL TRIAL.
Keywords:Young Patients, Fracture Neck Femur, CC Screw, DHS
Orthopedic surgeons have struggled with intracapsular neck femur fractures for years, and their outcome and treatment remain uncertain, especially in younger patients. In an orthopedic emergency, an intracapsular femur fracture neck must be minimized with firm internal fixation to improve femoral head circulation and prevent nonunion and avascular necrosis. In India, sliding hip screws are used less for intracapsular neck femur fracture repair than cannulated screws. The purpose of this comparative study is to evaluate the outcomes of both fixation modalities as well as the factors influencing these fixations in the population.
Materials and Methods
This study, which was carried out in a tertiary care hospital in the orthopedics department, is prospective and randomized. It involved 60 patients who were randomly assigned to two groups. Thirty patients in Group A underwent surgery using three cannulated cancellous screws, while thirty patients in Group B underwent surgery using dynamic hip screws.
It was discovered that DHS is not only more stable but also permits improved compression across the fracture, enabling early union and mobilization. In patients treated with DHS, non-union was not a problem; in contrast, four patients treated with CC screws developed non-union. In the study, patients managed with DHS had an average union time of 13 weeks, whereas patients managed with CC screws had an average union time of 17 weeks.
For the management of all patients with fractured neck femur i/v/o, early mobilization, early union, and a decreased risk of non-union are advised. DHS with a derotation screw is one recommended method.
Based on the comparative study, dynamic hip screws with derotation screws are preferred over cannulated cancellous screws for intracapsular neck femur fractures due to their stability, early union, and reduced risk of non-union. Better patient outcomes require early mobilization.
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Copyright (c) 2023 Dilip Kumar Chaudhary, Rajnish Kumar, Sunny Kumar
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