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Open AccessArticle

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

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Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18–20, A–1090 Vienna, Austria
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Department: Medical School, University College London, London WC1E 6BT, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(10), 1670; https://doi.org/10.3390/jcm8101670
Received: 25 September 2019 / Accepted: 2 October 2019 / Published: 12 October 2019
(This article belongs to the Section Orthopedics)
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. View Full-Text
Keywords: osteosynthesis; femoral neck fractures; intracapsular; dynamic hip screw; cannulated screw; avascular necrosis osteosynthesis; femoral neck fractures; intracapsular; dynamic hip screw; cannulated screw; avascular necrosis
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Widhalm, H.K.; Arnhold, R.; Beiglböck, H.; Munteanu, A.; Lang, N.W.; Hajdu, S. 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. J. Clin. Med. 2019, 8, 1670.

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