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Research Paper | Orthopaedic Surgery | India | Volume 12 Issue 5, May 2023
A Prospective Interventional Study on the Functional and Radiological Outcome in Vertical Angle Femoral Neck Fractures in Young Adults Treated by Lag Screw with Dynamic Hip Screw
Kanti Lal Roat [2] | Narendra Joshi [2] | Rakesh Dhukia [2] | Mayank Ganeshani [2] | Shivendra Rathore [2]
Abstract: Introduction: The vertical angle fractures (Pauwels type III) are a challenging clinical scenario to manage and are more commonly encountered in young patients. With proper patient selection, proper instruments, quality image intensifier and standard surgical technique, Dynamic Hip Screw along with a lag screw is a highly rewarding surgery in Pauwels type III fracture neck of femur in patients where we want to preserve the femoral head. Methodology: This prospective study was conducted on 40 cases with Pauwels type III fractures neck of femur coming to casualty of Sawai Man Singh Medical College and Hospital Jaipur (Rajasthan) during the study period from July 2020 to September 2022.135 degree Dynamic Hip Screw (DHS), 6.5mm & 16mm partially threaded cancellous screws were used as implants. Depending upon the position of comminution as evident on CT scan insertion of screws was done. Follow up was done at 2 weeks, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 1year. Harris Hip Score was measured at the end of 1year. Result: Mean age of the patients was 38.28+9.39 years. M: F ratio of 7: 3. Mean Harris Hip Score was 89 with the maximum score being 100 and the minimum score being 83. On the basis of patient?s own assessment, Out of 40 patients, 28 (70%) patients graded themselves as excellent grade followed by 12 (30%) patients who reported as good.28 (70%) patients reported no pain post - surgery. Only 9 (22.5%) study participants reported requirement of single cane for long walking for a period of three to six months. On climbing stairs after surgery, 19 (47.5%) required support of railing. Among 40, 28 (70%) patients post - surgery can wear shoe and shocks with ease & 35 (95%) of the patients can sit in ordinary chair for one hour post - surgery. Conclusion: After studying thoroughly, one can safely conclude with proper patient selection, proper instruments, quality image intensifier and standard surgical technique, Dynamic Hip Screw along with a lag screw is a highly rewarding surgery in Pauwels type III fracture neck of femur in patients where we want to preserve the femoral head.
Keywords: Pauwels type III, Fracture neck of femur, Lag screw, Dynamic hip screw, Vertical high shear Fracture neck of femur
Edition: Volume 12 Issue 5, May 2023,
Pages: 2252 - 2257