STUDY OF DHS VERSUS CANNULATED CANCELLOUS SCREWS IN PAUWELS TYPE II AND III FRACTURE NECK FEMUR IN YOUNG ADULTS

Abstract

Fracture neck of femur is a specic type of intracapsular hip fracture and is called unsolved fracture [1]. Fracture neck of femur are associated with low energy falls in the elderly[2]. In younger pateints sustaining a femoral neck fracture, the cause is usually high energy trauma such as a substantial height or motor vehicle accidents [3]. Young pateints with femoral neck fractures will require treatment with emergent open reduction internal xation.[4] Vertically oriented fractures pauwel type 2 or 3 are more common in younger and high energy trauma pateints. With displaced fractures in younger pateints,the goal is to achieve anatomic reduction through emergent open reduction internal xation.[5] . Avascular necrosis and nonunion increase risk factor with increased initial displacement and failure to obtain an anatomic reduction.[6]. Internal xation is less invasive, can preserve the femoral head, and the hip function is better after healing [7]. However, orthopedic surgeons are often perplexed by postoperative complications of internal xation, such as avascular necrosis, non-union, implant failure, and reoperation [8,9]. Achieving an anatomic reduction and stable xation are imperative, other factors such as timing of surgery, role of capsulotomy and method of xation remain debatable . Femoral neck fractures with a vertical orientation have been associated with an increased risk of failure as they are both axial and rotation unstable and associated with higher rates of nonunion compared to the more horizontally oriented fractures sparking debate over the most effective internal xation device. Singh et al in their study concluded that DHS is a better implant than CC screw in management of fracture neck femur in young adults in pauwels type II and III in terms of functional outcome but complication rate does not depend on the implant selection.