Challenges of biplane double-supported screw fixation technique for osteosynthesis of femoral neck fractures in the South Indian population

Objectives: Controversy exists in the management of neck of femur fractures. Insufficient reduction, unstable fixation, and poor–quality osteoporotic bone result in complications. This study was conducted to evaluate the functional and radiological outcomes of femoral neck fractures managed by the biplane double-supported screw fixation (BDSF) technique in the South Indian population, which is predominantly short profile. Methods: A prospective study was conducted among subjects aged (18–60 years) with femoral neck fractures over 2 years. All participants underwent fixation with the BDSF technique. Patients were followed up regularly for 12 months postoperatively. Harris hip score and radiological assessment were assessed. Complications such as screw backout, implant failure, and avascular necrosis (AVN) were assessed during the follow-up. Results: Of the 60 patients, 43 (71.7%) were males and 17 (28.3%) females. The mean age was 44 ± 11.2 years. Pair-wise post hoc test was statistically significant ( P < 0.001). Harris hip scores decreased with the patient’s age increasing. The radiological union was noted in 49 cases. Eleven (18%) cases had non-union. Seven (11%) had AVN of the femoral head, four (6%) had screw backout with varus collapse, and 3 had (5%) varus mal-reduction. Conclusion: The functional outcomes of femoral neck fractures managed by the biplane BDSF technique were excellent. This technique was a safe, viable, and cost-effective option for neck of femur fractures in old and young populations. Further comparative studies and randomized control trials would be beneficial in providing evidence.