Osteosynthetisch versorgte Schenkelhalsfrakturen des jungen und alten Patienten

Abstract

Treatment of intracapsular femoral neck fractures, especially in elder patients, has been a topic of ongoing discussion. This study analyzes the results of 97 osteosynthetically-treated femoral neck fractures. It had to be proved whether the Dynamic Martin Screw (DMS) represents an alternative to the already existing implantation devices. Until now no systematic results have been reported on this topic. Over a period of seven years, 389 patients with femoral neck fractures were treated. In 101 of these patients operations with preserved femoral heads were carried out. In order to ensure stabilization, compression screw stabilization (3 AO cancellous screws) was performed in 4 cases, the Dynamic Hip Screw (DHS) in 34 cases and the DMS in 63 cases. Observation criteria used in this retrospective study were osseous consolidation, pseudarthritis rate, complications involved with implantations, aseptic femoral head necrosis, as well as operating time. Period of observation was on average 8.5 years, with 65 years being the average age of the patients. Head necrosis was identified in 6 of 34 cases (17.6%) for the DHS group and 12 of 63 cases (19%) for the DMS group (p=0.95). Operating time was significantly reduced with the DMS procedure (p=0.035). The DMS can be seen as an alternative implantation device for stabilizing medial intracapsular femoral neck fractures. In comparison with the DHS, the operating time could be significantly reduced.