Efficacy of dynamic hip screw with derotation screw in surgical management of basicervical fracture neck of femur

Background: Femoral fractures are associated with low energy falls in the elderly. Among internal fixation implants, the Dynamic Hip Screw (DHS) combined with the De-Rotational Screw (DS) is widely used. DHS+DS could provide better resistance to shear and rotation forces. Hence; the present study was conducted for evaluating the effectiveness of dynamic hip screw with derotation screw in surgical management of basicervical fracture neck of femur. Materials and Methods: Participants attending outpatient department of orthopaedics and admitted in Sri Siddhartha medical college & hospital presenting with Basicervical neck of femur fracture, who were willing to undergo surgery, were enrolled for the study. 34 subjects were enrolled. Follow up of Participant was at 6, 12 week and 6- and 12-month interval post-operative period to assess reduction in pain and ability to bear weight on affected limb and do daily activities according to modified Harris hip Score criteria. The data wase entered in Excel spread sheet. SPSS software (version 24) was used to analyses the data. Results: Mean age of the patients was 48.53 years. Duration from trauma to surgery was 4.3 days. Mean size of incision was 5.3 cm. Mean duration of surgery was 49.7 minutes. Mean blood loss was 176.6 ml. Mean duration of hospital stay was 12.3 days. Mean time to partial weight bearing was 3.2 weeks. Mean time to full weight bearing was 6.26 weeks. Mean fracture time was found to be 13.21 weeks. Fracture union rate was 100 percent. Mean Harris Hip score at preoperative, postoperative 6 weeks, postoperative 12 weeks, postoperative 6 months and postoperative 12 months was found to be 41.3, 62.3, 71.9, 77.1 and 89.7 respectively. Significant results were obtained while comparing the Harris hip score at different follow-up time intervals. While assessing the outcome, excellent results were seen in 67.65 percent of the patients while good outcome was seen in the 29.41 percent of the patients. One patient (2.94 percent) showed fair outcome. Superficial infections were seen in 8.82 percent of the patients. Conclusion: Closed reduction and internal fixation with Dynamic Hip Screw (DHS) and derotation screw is a safe and effective surgical procedure for the management of basicervical neck femur fractures with a high rate of union and excellent functional results.