Evaluation of functional and radiological outcome of transverse cancellous lag screw fixation technique in pauwels type 3 fracture neck of femur

Abstract

The study was conducted to evaluate the outcomes of transverse cancellous lag screw (TCLS) fixation in pauwels type 3 fracture neck of femur (NOF). 29 patients with pauwels type 3 fracture neck of femur were operated with transverse cancellous lag screws. Functional outcome was evaluated using Harris hip score while RUSH score was used to evaluate radiological outcome. The follow up period was 6 months. Quantitative variables were compared using unpaired t- test/Mann- Whitney test. Qualitative variables were compared using Chi-Square test /Fisher’s exact test. Pearson correlation coefficient/Spearman rank correlation coefficient was used to find out the correlation between quantitative variables. A p value of <0.05 was considered statistically significant. Mean Harris hip score was 84.86 with excellent outcomes in 44.82% of patients. Mean RUSH score was 26.55 at the end of 6 month follow up. The mean time to union was 4 months and the union rate was 93.10%. Over all TCLS fixation technique had good results in our study. This construction not only improves the compression pressure across the fracture site, also offer a multi-plane structure to lock the fracture ends. The addition of the transverse lag screw (inserted perpendicularly to the fracture line) allows optimum control of shear forces in the fracture ends. The transverse screw also provides rigid cortical support by transferring the bending moments from the femoral head and neck to the enhanced posterior lateral cortical support, which harmonized the function of the calcar femorale.