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A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients

One of the most common fractures is that of the intracapsular femoral neck; however, the optimal implant for head-preserving treatment remains controversial. The aim of the study was to compare the outcomes of treating undisplaced intracapsular femoral neck fractures with either the dynamic hip scre...

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Autores principales: Widhalm, Harald Kurt, Arnhold, Richard, Beiglböck, Hannes, Munteanu, Alexandru, Lang, Nikolaus Wilhelm, Hajdu, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832900/
https://www.ncbi.nlm.nih.gov/pubmed/31614881
http://dx.doi.org/10.3390/jcm8101670
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author Widhalm, Harald Kurt
Arnhold, Richard
Beiglböck, Hannes
Munteanu, Alexandru
Lang, Nikolaus Wilhelm
Hajdu, Stefan
author_facet Widhalm, Harald Kurt
Arnhold, Richard
Beiglböck, Hannes
Munteanu, Alexandru
Lang, Nikolaus Wilhelm
Hajdu, Stefan
author_sort Widhalm, Harald Kurt
collection PubMed
description One of the most common fractures is that of the intracapsular femoral neck; however, the optimal implant for head-preserving treatment remains controversial. The aim of the study was to compare the outcomes of treating undisplaced intracapsular femoral neck fractures with either the dynamic hip screw (DHS) or the double cannulated screw fixation (CSFN). This retrospective cohort study analysed the data of 453 patients, with a mean age of 76.9 years, whose intracapsular fractures were treated with the DHS or CSFN between 2005 and 2013. The analysis focused on the rates of revision surgeries and complications; however, the impact of confounding exogenous factors, such as smoking and alcohol, were also considered. No significant difference was observed between the revision rates of DHS and CSFN (15.0% vs. 13.1%; p = 0.565). According to the complication rate, the advantage in favour of the CSFN was not significant (20.5% vs. 13.1%, p = 0.038). The use of the DHS was associated with a 13 min longer surgery (p < 0.0001) and a one day longer hospitalization (p = 0.242). Excessive consumption of alcohol was associated with an increased incidence of avascular necrosis (18.6% vs. 8.7%, p = 0.035). The choice of implant showed no significant impact on rates of revision surgery and complications. In terms of socioeconomic factors, the fixation with two cannulated screws was more favourable, making it the more cost-effective and less stressful method.
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spelling pubmed-68329002019-11-25 A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients Widhalm, Harald Kurt Arnhold, Richard Beiglböck, Hannes Munteanu, Alexandru Lang, Nikolaus Wilhelm Hajdu, Stefan J Clin Med Article One of the most common fractures is that of the intracapsular femoral neck; however, the optimal implant for head-preserving treatment remains controversial. The aim of the study was to compare the outcomes of treating undisplaced intracapsular femoral neck fractures with either the dynamic hip screw (DHS) or the double cannulated screw fixation (CSFN). This retrospective cohort study analysed the data of 453 patients, with a mean age of 76.9 years, whose intracapsular fractures were treated with the DHS or CSFN between 2005 and 2013. The analysis focused on the rates of revision surgeries and complications; however, the impact of confounding exogenous factors, such as smoking and alcohol, were also considered. No significant difference was observed between the revision rates of DHS and CSFN (15.0% vs. 13.1%; p = 0.565). According to the complication rate, the advantage in favour of the CSFN was not significant (20.5% vs. 13.1%, p = 0.038). The use of the DHS was associated with a 13 min longer surgery (p < 0.0001) and a one day longer hospitalization (p = 0.242). Excessive consumption of alcohol was associated with an increased incidence of avascular necrosis (18.6% vs. 8.7%, p = 0.035). The choice of implant showed no significant impact on rates of revision surgery and complications. In terms of socioeconomic factors, the fixation with two cannulated screws was more favourable, making it the more cost-effective and less stressful method. MDPI 2019-10-12 /pmc/articles/PMC6832900/ /pubmed/31614881 http://dx.doi.org/10.3390/jcm8101670 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Widhalm, Harald Kurt
Arnhold, Richard
Beiglböck, Hannes
Munteanu, Alexandru
Lang, Nikolaus Wilhelm
Hajdu, Stefan
A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients
title A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients
title_full A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients
title_fullStr A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients
title_full_unstemmed A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients
title_short A Comparison of Dynamic Hip Screw and Two Cannulated Screws in the Treatment of Undisplaced Intracapsular Neck Fractures—Two-Year Follow-Up of 453 Patients
title_sort comparison of dynamic hip screw and two cannulated screws in the treatment of undisplaced intracapsular neck fractures—two-year follow-up of 453 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832900/
https://www.ncbi.nlm.nih.gov/pubmed/31614881
http://dx.doi.org/10.3390/jcm8101670
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