Comparison of Frequency of Non-Union in Patients of Displaced Fracture Neck of Femur Treated with Dynamic Hip Screw versus Cannulated Screw Fixation

Femoral neck fracture are common presentation in orthopedic emergency and need urgent intervention with good outcomes.

Objectives: To compare frequency of non-union in patients of displaced neck of femur fracture in patients treated with dynamic hip screw versus cannulated screw fixation.

Materials and Methods: This Randomized control trial Study was conducted in the Department of Orthopedics and Trauma, Medical Teaching Institute Lady Reading Hospital Peshawar from April, 2022 till March, 2023 on 174 patients of either gender with age range 20-50 years, community ambulant having displaced neck of femur fracture (Garden type III and IV) presented within 3 days. Polytrauma patients with multiple fractures, Pathological femoral neck fracture and Open femoral neck fractures were excluded from the study. Patients were divided randomly in two equal groups using computer generated random numbers squares. Identical standard surgical techniques was adopted for dynamic hip screws and cannulated screw fixation. All surgeries were performed under general/spinal anesthesia on traction table and image intensifier. An adequate surgical incision was given in each group. Fracture was reduced under image intensifier with attainment of Garden index. Data was entered and analyzed by using SPSS version 22.

Results: In our study 87 patients were enrolled in each group. Mean age was 35.33±10 years in group A and 34.2±8.5 years in group B. There were 52.9% males in group A and 58.6% in group B, females were 47.1% in group A and 41.4% in group B. Mean duration of fracture was 2.53±0.7 days in group A and 2.36±0.84 days in group B. Non-union was present in 6.9% in dynamic hip screw group and 16.1% in cannulated screw group, p-value 0.05.

Conclusion: Dynamic hip screw has less non-union rate as compared to cannulated to cannulated screw.