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A Journal on Internal Medicine
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6
Panminerva Medica 1999 September;41(3):233-7
Dynamic hip screw versus 3 parallel screws in the treatment of garden 1+2 and garden 3+4 cervical hip fractures
From the Department of Orthopaedic Surgery, Rigshospitalet University of Copenhagen, Denmark, Department of Orthopaedic Surgery, Frederiksberg Hospital University of Copenhagen, Denmark
Objective. The main objective of this study was to evaluate the failure rate following operations of undisplaced and displaced cervical hip fractures with a dynamic hip screw compared with 3 parallel screws.
Design. The study was retrospective. The minimum follow-up time was 1 year. The data tta collested between January 1990 and December 1993.
Setting. University Hospitals.
Patients. A total of 456 patients (352 women and 104 men) with cervical hip fractures were included. The mean age was 80 years (range 51-100 years).
Intervention. This was internal fixation of the fractured hip with a dynamic hip screw or 3 parallel screws.
Main outcome measures. Failure was defined as nonunion, fixation failure or avascular necrosis and reoperation was found indicated. The 3 months mortality rate, the wound infection rate, the delay between admission and time of surgery and the blood transfusion requirement were also recorded.
Results. A total of 456 cervical hip fractures were operated with a dynamic hip screw or 3 parallel screws. The failure rate for fractures treated with a dynamic hip screw was 14/98=14% for Garden 1+2 fractures and 43/108=40% for Garden 3+4 fractures. The failure rate for fractures treated with 3 parallel screws was similar: 23/154=15% for Garden 1+2 fractures and 38/196=40% for Garden 3+4 fractures. The average follow-up time was 2.5 years.
Conclusion. Operation of cervical hip fracture with a dynamic hip screw or 3 parallel screws seem to give similar results.