Table of Contents
ISRN Orthopedics
Volume 2014 (2014), Article ID 257871, 7 pages
http://dx.doi.org/10.1155/2014/257871
Research Article

Dynamic Hip Screw for the Treatment of Femoral Neck Fractures: A Prospective Study with 96 Patients

1Orthopaedics and Traumatology, Federal University of Health Sciences of Porto Alegre and Santa Casa de Misericordia of Porto Alegre, Rua Leopoldo Bier, 825/cj 403, 90620-100 Porto Alegre, RS, Brazil
2Department of Orthopaedics and Traumatology/Pediatrics, Santa Casa de Misericordia of Porto Alegre, Avenida Independência, 155, 90035-074 Porto Alegre, RS, Brazil
3Department of Orthopaedics and Traumatology/Hip Surgery, Santa Clara Hospital, Santa Casa de Misericordia of Porto Alegre, Reception 8, Rua Professor Annes Dias, 135, 90020-000 Porto Alegre, RS, Brazil
4Department of Physical Therapy, Santa Clara Hospital, Santa Casa de Misericordia of Porto Alegre, 2nd Floor, Rua Professor Annes Dias, 135, 90020-000 Porto Alegre, RS, Brazil
5Department of Physical Therapy, Federal University of Health Sciences of Porto Alegre, Rua Sarmento Leite, 245, 90050-170 Porto Alegre, RS, Brazil

Received 4 January 2014; Accepted 2 February 2014; Published 24 April 2014

Academic Editors: G. Babis and V. S. Nikolaou

Copyright © 2014 Carlos Roberto Schwartsmann et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To study the correlation between avascular necrosis and the demographics, time elapsed from fracture to surgery, quality of reduction, Garden classification, and the position of the screw following use of the dynamic hip screw (DHS) in the treatment of subcapital neck fractures. Methods. A prospective study of 96 patients with subcapital neck fractures was carried out in a faculty hospital. Patients underwent surgery with closed reduction and internal fixation with DHS. Results. There were 58% male and 42% female patients, with a mean age of 53 years (+/−14). In terms of Garden classification, 60% were Garden IV, 26% were Garden III, and 14% were Garden II. Nonunion was observed in three cases (3%) and was treated with valgus intertrochanteric osteotomy, in all cases leading to successful healing. Avascular necrosis was observed in 16% of patients. The positioning of the screw into the femoral head showed a significant correlation with necrosis. Conclusions. The incidence of necrosis in patients under the age of 50 years is twice as high as that in older patients. Displacement is a predictive factor regarding osteonecrosis and is associated with a high and anterior position of the screw in the femoral head. Level II of evidence. Study Type: therapeutic study.