Subcapital fractures of the femur. Treatment by reduction and fixation and 3 spongy bone screws.

The authors reviewed 21 cases of subcapital fracture of the femur treated by reduction and fixation with 3 spongy bone screws (AO type) between 1980 and 1983. There were 4 failures (2 non-union and 2 ischaemic necrosis, one definite and one suspected). In all patients with a reasonable life expectancy the treatment should be reduction and fixation, but the technique must be extremely accurate. If open reduction is necessary to ensure perfect reduction, it must be by the anterior route so as not to inflict further damage on the blood supply. Fixation must be rigid and sustained. This can be best achieved by using 3 screws of the AO spongy type which also ensures a degree of compression which enhances consolidation.