Prospective randomized controlled trial comparing dynamic hip screw and screw fixation for undisplaced subcapital hip fractures

摘要: Background Neck of femur fractures (NOFFs) are a common cause morbidity and mortality in our community. Minimally displaced intracapsular treated with internal fixation by two-hole dynamic hip screw (DHS) or three partially threaded cancellous screws. Data to support the superiority one limited. This prospective randomized controlled trial compares outcomes these two methods. Methods We prospectively recruited patients over 50 years, an acute fracture subcapital NOFF, who walked lived independently, were cognitively intact. They into DHS groups followed up for 2 years (overall 75.9%). Outcomes mortality, revision, loss fixation, avascular necrosis, surgical complications, WOMAC, Harris score SF-12 measured. Results We 62 (31 DHS, 29 screws, failed consent). Six deaths (19.3%) seen each group. A total 3.2% (1 out 31) 10.3% (3 29) required re-operation (P = 0.272). There was no statistical significant difference patient satisfaction, quality life (QoL), radiological union osteonecrosis. trends towards better functional scores QoL particularly at 1 year 0.0061), but higher rate. combined transition institutional care 40.0% (24 60) years. Conclusions This study found between screws treatment NOFFs fit, independent population, we high level physical decline previously independently ambulating patients. large, multicentre will be differentiate methods.