Short term outcomes following biplane double supported screw fixation of femoral neck fractures in adults: a prospective observational study

Femoral neck fractures are common among the elderly population. Non-union is a common complication of these fractures, despite various fixation options. Nonunion results in considerable morbidity and impaired function. Biplane double-supported screw fixation (BDSF) is a newer technique for femoral neck fractures, demonstrating superior fixation strength in biomechanical studies. We conducted this prospective observational study to evaluate the fixation strength of BDSF in adult femoral neck fractures, focusing on fracture union, loss of reduction over one year, and functional outcomes at the end of one year. Loss of fracture reduction was assessed using radiological parameters, while functional outcomes were measured with the modified Harris hip score (MHHS) and Parker mobility score (PMS). We recruited 19 patients aged 18-65 years who were treated using the BDSF technique and followed them for a year. The radiological and functional parameters were measured at regular intervals. Only 17 patients reported for final follow-up at one year. The mean neck shaft angle reduced by 6.35 degrees and the mean neck length decreased by 1.02 cm over 12 months. Two patients had expired during the follow up period and 17 patients were available for the final follow up at 1 year. Fracture union was achieved in 16 patients. No patient had fixation failure. Both the MHHS and PMS showed significant improvement at 1 year and 6 months respectively. BDSF provides strong fixation and good union rates. Although there was a reduction in neck-shaft angle and neck length, our study showed excellent functional outcomes.