Fixation of femoral neck fractures. Comparison of the Uppsala and von Bahr screws.

In a prospective randomized study, a newly developed so-called Uppsala technique for internal fixation of femoral neck fractures was compared with the von Bahr technique. The series consisted of 222 consecutive patients, 167 women and 55 men, with a mean age of 80 years. Half of the patients were randomized to each treatment group. During the first postoperative year, 18 failures occurred in the Uppsala group, compared with 39 in the von Bahr group (P less than 0.01). Of 128 patients without pain at 4 months, 9 developed failures, compared with 29 of the 37 that had pain at this time (P less than 0.001). We conclude that the new technique gives better results during the first postoperative year and that most failures occur among those with pain at 4 months. Follow-up radiography is indicated only in patients with pain at 4 months.