Article

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

1Department of Orthopedic Surgery, 2Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv Univesity, Tel Aviv, Israel.
Journal of orthopaedic trauma (Impact Factor: 1.54). 07/2013; DOI: 10.1097/BOT.0b013e3182a225fa
Source: PubMed

ABSTRACT The 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.
Comparison of a prospective collected data to a historical control group (retrospective).
One community teaching hospital.
Seventy-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.
Treatment 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 one year follow-up.
One patient in Group 1 (3.2%) and 22 (46.8%) in Group 2 had a nonunion (p = 0.0001). Four Group 1 patients (12.9%) and 16 Group 2 patients (34.0%) underwent revision surgery (p = 0.036). Four patients in Group 1 (12.9%) and four Group 2 patients (8.5%) 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, i.e., by 77% (p = 0.018).
Performing internal fixation by a fixed angle fixation device decreased nonunion rates and revision rates. It did not affect the rate of osteonecrosis.

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