L. Lokanadha Rao 1 , Satish Kumar Dake 2 , K. Surya Vardhan 3 , Vikas Rathod 4 , V. Sivani 5 , P. Ravi Chandra 6 , P. Vamsi Krishna 7 , M. Ravi 8
Fractures of neck of femur have always presented great challenges to the orthopaedic surgeons. This remains, even today, an unsolved fracture as far as treatment and results are concerned. Results depend upon the extent of injury, timing of surgery and adequacy of reduction and fixation. Fixation with cannulated cancellous screws is usually adequate for femoral neck fractures. Lateral cortex plays a very important role in screw fixation. AIMS AND OBJECTIVES To study the effectiveness of cannulated cancellous screw fixation for treatment of fracture of neck of femur in adults. MATERIALS AND METHODS This study was conducted at Andhra Medical College, King George Hospital, Visakhapatnam, AP from Nov 2013 to Oct 2015. The patients with intracapsular fracture of neck of femur are evaluated with pre-operative X-rays of pelvis with both hips and X-ray of the concerned hip joint both in anteroposterior and lateral views and their outcome was evaluated postoperatively after fixation with cancellous screws. The outcome is evaluated in terms of pain relief, extent of ambulation achieved after surgery. The classifications we followed are Pauwel’s and Garden’s classification of fracture of neck of femur. The patients were followed up to one year to assess the functional outcome. OBSERVATION AND RESULTS A good result was obtained in 66.1% of the patients, excellent in 23.2%, fair in 3.8% and poor result in 6.9% of the patients. Complications such as Non-union & avascular necrosis in one case, Non-union and Extrusion of screws in one case, Cut through of screws into articular surface leading to painful joint in one case. Most of the cases of intracapsular neck of femur were in the age group of 31-40 years. There was male preponderance as shown in this study (69%). CONCLUSION By the usage of multiple cannulated cancellous lag screws, compression effect at the fracture site is achieved, it also avoids re-displacement and rotations. The implant occupies less volume in the small-sized femoral necks of South Indian patients allowing better osteosynthesis of intracapsular fracture of neck of femur. Multiple cannulated cancellous screw fixation for intracapsular fracture of neck of femur is an easy, safe & useful procedure with encouraging results.
