Outcome of AO Screw Fixation for Intra-Capsular Neck of Femur Fracture
Objective: To assess the outcome of AO screw fixation for intra-capsular neck of femur fracture.
Method: This Quasi experimental study was performed at the Orthopaedic and Trauma Unit, Khyber Teaching Hospital Peshawar from June 2014 to June 2017. All the patients had acute intra-capsular neck of femur fracture at the time of presentation. Garden’s classification was used to stratify patients. On antero-posterior and lateral imaging Garden‘s alignment index used to evaluate anatomic reduction for fractures. All patients underwent AO Screw because its minimally invasive and time-tested device fixation. Postoperative complications were evaluated during follow up periods and followed for eighteen months to two years. The outcome of fixation was assessed in terms of avascular necrosis of head of femur, non-union and need for secondary procedures.
Results: The study comprised total of 55 patients. There were 43 (78.18%) males and 12 (21.82 %) females. Majority 38 (69.03%) suffered from intra-capsular neck of femur fracture secondary to fall. In 31(56.26%) Right hip fractured while in remaining Left side. At the end of study period 46 (83.63%). patients healed un eventfully while 06(10.90%) patients suffered from avascular necrosis (AVN) of the head of femur. In 02(3.63%) Screws were cut out while in 01(1.8%) patient fibular strut graft was needed along with revision of AO Screw fixation to manage non-union.
Conclusion: Intra-capsular displaced neck of femur fracture (Garden type two and three) fixation with AO Screw produces remarkable results in good hip function less than 60 years old. However, there is a high chance of complications if fracture not reduced anatomically.
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