Treatment of Femoral Neck Fractures with Dynamic Hip Screw in Young Adults

Abstract

Dynamic hip screws have been a mainstay of treatment for intertrochanteric fractures of the proximal femur and are also used to treat femoral neck fractures. Femoral neck fractures are usually common in older age but can also present in younger individual usually due to high energy trauma. Treatment of these fractures in young adults is debated due to higher energy demands of the age and need to salvage the bone instead of opting for a hemi arthroplasty or total hip arthroplasty as with older patients. Different other treatment options such as multiple cannulated screws have also been proposed but there still lies no consensus for the ideal treatment of such fractures. Displaced fractures are commonly associated with a vascular necrosis of the femoral head and multiple researches have been performed in this regard but if success of union occurs after a Dynamic hip screw is performed, the patient is able to regain his near physiological hip. Good bone quality and no comorbids usually present as an advantage in younger patients but still the surgery haunts orthopedic surgeons with its non-union and a vascular necrosis rates. Good anatomical reduction and stable fixation remains a mainstay of the treatment and can be perpetuated by a further use of a de-rotation screw.