title: Fixation of femoral neck fractures with three screws: results and complications.
abstract: OBJECTIVE
  To evaluate the results and complications of femoral neck fractures treated with internal fixation with three screws with an average follow-up of three years.
  
  
  METHODS
  Thirty seven patients operated upon between June 2000 and May 2005 for fractures of the femoral neck with three screws were identified as the study population. The final results of 26 patients (11 male, 15 female, with an average age of 39.8, range 16-69) that had a minimum of two year follow-up (average 37 months, range 24-64 months) were evaluated. Those patients that had additional fractures were not included in the evaluation. Preoperatively based on Garden classification four patients (15%) were Type I, eight patients (31%) were type 2, six patients (23%) were type three and eight patients (31%) were type 4. Functional results were evaluated according to the UCLA hip score.
  
  
  RESULTS
  The average time to union was 5.5 months (range 3-12 months). One patient did not achieve union and a total hip replacement was done in the 15th postoperative month. Four patients had avascular necrosis (AVN) of the femoral head. The incidence of AVN in patients who had an operation within 24 hours of fracture was 9.5% while 40% in patients operated later than that. In patients with AVN one required a total hip replacement, another required treatment with bipolar hemiarthroplasty, the other two patients did not require further operations. One patient underwent bipolar hemiarthroplasty after screw pullout occurred on the 35th postoperative day. Fifteen patients (58%) had excellent results, five (19%) had good, 5 (19%) had moderate results and one (4%) had a poor result.
  
  
  CONCLUSIONS
  Operative treatment with internal fixation using three screws in femoral neck fractures in the first 24 hours after a fracture gives favourable results in young patients that are too young to be considered for arthroplasty.
authors.affiliation: Department II of Orthopaedics and Traumatology, Atatürk Research and Training, Izmir, Turkey. firatseyf@yahoo.com
authors.forename: Fırat
authors.initials: F
authors.lastname: Seyfettinoğlu
authors.forename: Onder
authors.initials: O
authors.lastname: Ersan
authors.forename: Emrah
authors.initials: E
authors.lastname: Kovalak
authors.forename: Fatih
authors.initials: F
authors.lastname: Duygun
authors.forename: Barış
authors.initials: B
authors.lastname: Ozsar
authors.forename: Yalım
authors.initials: Y
authors.lastname: Ateş
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult