Dynamic hip screw versus 3 parallel screws in the treatment of garden 1 + 2 and garden 3 + 4 cervical hip fractures.

OBJECTIVE

The main objective of this study was to evaluate the failure rate following operations of undisplaced and displaced cervical hip fractures with a dynamic hip screw compared with 3 parallel screws.

DESIGN

The study was retrospective. The minimum follow-up time was 1 year. The data tta collested between January 1990 and December 1993.

SETTING

University Hospitals.

PATIENTS

A total of 456 patients (352 women and 104 men) with cervical hip fractures were included. The mean age was 80 years (range 51-100 years).

INTERVENTION

This was internal fixation of the fractured hip with a dynamic hip screw or 3 parallel screws.

MAIN OUTCOME MEASURES

Failure was defined as nonunion, fixation failure or avascular necrosis and reoperation was found indicated. The 3 months mortality rate, the wound infection rate, the delay between admission and time of surgery and the blood transfusion requirement were also recorded.

RESULTS

A total of 456 cervical hip fractures were operated with a dynamic hip screw or 3 parallel screws. The failure rate for fractures treated with a dynamic hip screw was 14/98 = 14% for Garden 1 + 2 fractures and 43/108 = 40% for Garden 3 + 4 fractures. The failure rate for fractures treated with 3 parallel screws was similar: 23/154 = 15% for Garden 1 + 2 fractures and 38/196 = 40% for Garden 3 + 4 fractures. The average follow-up time was 2.5 years.

CONCLUSION

Operation of cervical hip fracture with a dynamic hip screw or 3 parallel screw seem to give similar results.