Role of Biplane Double Supported Screw Fixation For Fracture Neck Femur In Elderly Population: A Prospective Study

Abstract

Introduction: The treatment of fracture neck femur varies according to the age of patient, the displacement of fracture fragments and the duration of the fracture. Various treatment options available for elderly are screw fixation, hemiarthroplasty and total hip arthroplasty. Materials and Methods: This is a prospective study done at authors institutes between January 2014- December 2016. 30 patients aged more than 50 years who sustained fracture neck femur were included in the study. 3 patients were lost to follow up and 2 patients died due to medical comorbidities. Out of the 25 remaining patients, 17 were males and 8 were females and they were operated by the biplane double supported screw fixation method (BDSF TECHNIQUE) and were followed up for a period of two years. The final Harris Hip Score at the last follow up was calculated. Results: Out of the 25 patients, the union was achieved in all the patients. The mean duration of union was 10 weeks. 1 patient had progressive femoral head resorption due to chondrolysis resulting in antalgic gait and unbearable pain and underwent total hip arthroplasty. The mean harris hip score was 81.2 Conclusion: In elderly patients with osteoporosis and in those patients who can not afford arthroplasty or in those patients where arthroplasty is contraindicated, BDSF method is an alternate method for fixing fracture neck femur.

Role of Biplane double support screw fixation for fracture neck of femur in elderly population

“…Moreover, due to the biplane placement, enough space for a third screw is provided, whereas in the conventional methods for fixing neck femur, only one or a maximum of two screws can be placed at an obtuse angle. 18 Regarding demographic characteristics, the age of the patients ranges from 51 to 72 years, 65% of patients were males, and in accordance with our results, the study of Kalia et al 19 There seems to be a lot of controversy regarding the cannulated screw fixation for fracture neck femur like the number of screws to be used, configuration of screws and their position in head and neck. The method most widely practiced by surgeons for fixing the fracture neck femur is by three cancellous screws placed parallel to each other and various authors have reported the failure rate to be as high as 20-42%.…”

The ‘Unsolved’ Fracture Neck of Femur– A Comprehensive Review

“…The middle and proximal screws are inserted first followed by the distal screw as they are perpendicular to the fracture surface. (Figure 7) [31,32].…”