CASE SERIES OF FOUR QUADRANT PARALLEL PERIPHERAL SCREW FIXATIONS FOR FRACTURED NECK OF FEMUR AND THEIR OUTCOME

Abstract

BACKGROUND Femoral neck fractures are usually observed in the elderly population after a simple fall or minor trauma. In contrast, in young adults, femoral neck fractures are uncommon and are often due to high energy trauma caused by road traffic injuries, work injuries, or fall from a height. The surgical management of femoral neck fractures comprises various options: a) Closed or open reduction with internal fixation of the fracture with screw fixation, b) hemiarthroplasty and c) total hip arthroplasty. Selection of the mode of treatment depends on the patient's age, level of activity, medical comorbidities, degree of bone density, and degree of displacement of the femoral head. We hereby present results of a modified screw fixation technique (Four Quadrant Parallel Peripheral Screw Fixation) in femoral neck fractures of both young and old patients. MATERIALS AND METHODS Fifty patients aged 35 - 70 years with fractured neck of femur and operated in our hospital were included in this study. They were treated with closed reduction under image intensifier control and fixed with four quadrant parallel peripheral cannulated cancellous screws. Functional and Radiological results were evaluated periodically. RESULTS The functional outcome was evaluated with a new six-point functional hip score advocated by Satish et al. Radiologically fracture united within 3 months period of time. Out of 50 patients, two patients had developed osteonecrosis. They were treated by screw removal and converted to Hemiarthroplasty. CONCLUSION The four quadrant parallel peripheral (FQPP) screw fixation technique, allows controlled collapse, gives good stability, and avoids fixation failure and good bone healing in femoral neck fracture in patient's >= 35 years of age.