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Dariush G Savadkoohi MD. Tehran University of Medical Sciences, Sina Hospital Comparision of Osteosynthesis of femoral neck fractures by dynamic hip screw (DHS) fixation and multiple cannulated screws

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Page 1: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

Dariush G Savadkoohi MD.

Tehran University of

Medical Sciences,

Sina Hospital

Comparision of Osteosynthesis of femoral

neck fractures by dynamic hip screw

(DHS) fixation and multiple cannulated

screws

Page 2: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

PURPOSE OF THE STUDY

The aim of this randomized clinical trial

study was to evaluate patients treated by

osteo- synthesis for intra-capsular femoral

neck fractures with Dynamic Hip Screw

and Multiple cannulated screws

Page 3: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

MATERIAL and Methods From 2006-2011 , 114 patients with femoral neck

fractures were operated. 64 by dynamic hip screw and

50 patients with multiple cannulated screws.

The average follow-up was 3.5 years.

Evaluation regard to the occurrence of late

complications in relation to the length of time between

injury and surgery, quality of fracture reduction,

reduction failure and implant failure and nonunion of

neck of femur and reoperation

Page 4: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

A Case

Page 5: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

32 y

Male

Car accident

N/V intact

No wound

Page 6: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 7: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 8: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 9: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 10: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 11: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 12: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 13: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 14: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 15: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 16: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

Case

Page 17: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 18: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 19: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

CASE

Page 20: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 21: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 22: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 23: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

CASE

Page 24: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 25: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 26: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

CASE

Page 27: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 28: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 29: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral
Page 30: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

1 year follow up

Page 31: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

RESULTS In DHS group, Bone

union without

complications was achieved

in 73.4 % of the patients

within 12 months of

surgery. Late complications

were found in 26.% .

Page 32: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

RESULTS In the screw group,

fixation failure were seen

in 40% and late

complications were seen in

52%. The difference

between two groups seems

to be statistically

important.

Page 33: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

Screw failure

Page 34: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

DISCUSSION

The quality of reduction had a greater

effect on union than comparing with

femoral head necrosis. The DHS is

economic and available, with sufficient

results whose comparisons with the

literature data show that results are good .

In overall , results of screw fixation is lower

than DHS fixation

Page 35: Dariush G Savadkoohi MD. Tehran University of Medical ... › fileadmin › templates › fa › daneshkadaha › ... · MATERIAL and Methods From 2006-2011 , 114 patients with femoral

Thank you

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