Osteosynthesis of femoral neck fractures: dynamic hip screw (DHS) or mini-invasive Targon FN system?

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Abstract

Objectives: to investigate the long-term outcomes of femoral neck fractures that were surgically fixed using various types of extramedullary implants in patients aged 65 years and younger. Material and methods: We analyzed the clinical results of surgical treatment of femoral neck fractures by extramedullary osteosynthesis in 94 patients aged 38 to 65 years old (71 women and 23 men). The patients were divided into 3 groups according to AO/ASIF fracture classification. We used different techniques of osteosynthesis: with DHS or with Targon FN. In all patients the mental status rate SPMSQ), osteoporosis degree (Singh index), general somatic status (WHO scale) were evaluated in the preoperative period. We also evaluated next intraoperative parameters: duration of surgery, blood loss, quality of reduction, long of incision. In a year after surgery we assessed functional results (Harris Hip Score) and analysed postoperative complications. Results: It was found the inverse correlation (r = -0,8) of total preoperative parameters (WHO scale, the Singh index and mental status SPMSQ) and postoperative functional results on Harris Hip Score. With the reliability of p<0.05 the average rate of blood loss and length of skin incision were less in patients operated with Targon FN. In 12 months unsatisfactory results rate on Harris Hip Score was 12.7% in all study groups, great - 22,3%, good - 52.1%, and satisfactory - 12,9%. Complications rate in patients operated with DHS was 17,02%, and in patients operated with Targon FN - 18.1%. Conclusion: Minimally invasive osteosynthesis of femoral neck fractures (type B1 and B2 on AO/ASIF classification) allows to achieve the best results in compare with DHS osteosynthesis. Revealed complications such as screw migration, false joint formation and femoral head avascular necrosis were determined by impaired surgical technique and inadequate reduction.

About the authors

A. K. Dulaev

Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine; Pavlov First Saint-Petersburg State Medical University

Author for correspondence.
Email: noemail@neicon.ru
Russian Federation

A. N. Tsed

Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine; Pavlov First Saint-Petersburg State Medical University

Email: tsed@mail.ru
Russian Federation

I. G. Dzhusoev

Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine; Pavlov First Saint-Petersburg State Medical University

Email: noemail@neicon.ru
Russian Federation

K. N. Usubaliev

Pavlov First Saint-Petersburg State Medical University

Email: noemail@neicon.ru
Russian Federation

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