Dhs plus anti-rotational screw vs cannulated screws for femoral neck fractures: an analysis of clinical outcome and incidence regarding avn


Intertrochanteric fractures ; DHS ; Screws ; Elderly

Published online: Sep 30 2018

Michele Bisaccia , Paolo Ceccarini , Giuseppe Rinonapoli , Lorenzo Maria D i Giacomo , Julien Teodori , Andrea Schiavone , Cristina Ibanez Vicente , Giuseppe De Trana , Auro Caraffa

From the University of Perugia, Italy


The aim of this study was to compare the union time, functional outcome and complications in patients with femoral neck fractures treated with percutaneous cannulated screws or dynamic hip screw (DHS) plus antirotational screw.

We selected 117 consecutive patients having a hip fracture at any level within the Garden classification, treated at the Orthopedics and Traumatology Clinic in Perugia from 2010 to 2011. Average patient age was 67.8 years. Patients received either a treatment including cannulated screws (group I) or a DHS plate with anti-rotational screw(group II). All patients were followed up for a minimum of 1 year. The Harris Hip Score at 12 months was used to evaluate functional outcome.

Between the two treatment groups, the differences in union time and functional outcome were not statistically significant. Moreover blood loss was significantly lower in group I.

The results of our study did not suggest a superiority of one surgical technique over the other, when considering the union time and functional outcome. Regarding complications, the incidence of avascular necrosis was found to be significantly related to the Garden classification but not to synthesis type.

Level of evidence: IV, Retrospective case series