Okay BULUT, Mehmet TÜKENMEZ, Hüseyin DEMİREL, Tacettin ÇEKİN

Cumhuriyet Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı

Keywords: Femoral Neck Fractures, Adult, Internal Fixation, Cancellous Screw.


Introduction: We evaluated the results of patients with femoral neck fractures underwent multiple cancellous screws fixation either by percutaneous route without opening capsule or by opening capsule.
Patients and methods: One hundred and sixteen patients with femoral neck fractures were treated in our department between 1992 and 2002. Multiple cancellous screws were used in 49 (42%) patients. Forty-two of these patients were able to follow-up and recruited into this study. The patients treated until 1996 were evaluated retrospectively and then follow-up was made prospectively.
Results: The mean age of patients was 31.3 (17-50) years old. There were Garden type 1 in 6 patients, Garden type 2 in 14 patients, Garden type 3 in 12 patients and Garden type 4 in 10 patients. The mean operation time interval after fracture was 1.5 (0-21) days. The reduction was made without opening capsule in 14 patients and via opening capsule in 28 patients. Follow-up period was 70.5 (5-121) months. The mean union time of fractures was 5.2 months (range 3 to 7.5 months). Non-union in 3 (7.1%) patients, avascular necrosis in 7 (16.7%) patients were encountered. According to the evaluation criteria of our clinic the outcome was excellent 12 (28.6%), good in 16 (38.1%), average in 6 (14.3%) and inadequate 8 (19%) patients.
Discussion: We concluded that multiple cancellous screws fixation is still a useful procedure especially in non-displaced fractures. We also concluded that reduction should be made as soon as possible preferably without opening and fixation should be rigid. We also noted that the displacement of fracture at first position was significantly effective on outcome.