title: Osteosynthesis of unstable intracapsular femoral neck fracture by dynamic locking plate or screw fixation: early results.
abstract: OBJECTIVE
  The purpose of this study was to compare the postoperative radiologic and clinical outcomes of telescopic femur neck screws and small locking plate device (Targon FN) (group 1) with multiple cancellous screws (group 2) for displaced intracapsular femoral neck fractures.
  
  
  METHODS
  Comparison of a prospective collected data to a historical control group (retrospective).
  
  
  METHODS
  One community teaching hospital.
  
  
  METHODS
  Seventy-eight patients (group 1, 31; group 2, 47) underwent reduction and internal fixation of displaced intracapsular femoral neck fractures with either Targon FN device or multiple cancellous screws from March 2000 to July 2010. Their mean age was 53.7 years (SD: 16.4), and the mean follow-up period was 28.6 months.
  
  
  METHODS
  Treatment failure was considered to be either a nonunion, osteonecrosis, or revision surgery of any type. Treatment was regarded as successful in patients who did not show failure and had at least 1-year follow-up.
  
  
  RESULTS
  One patient in group 1 (3.2%) and 22 (46.8%) in group 2 had a nonunion (P = 0.0001). Four (12.9%) group 1 patients and 16 (34.0%) group 2 patients underwent revision surgery (P = 0.036). Four (12.9%) patients in group 1 and 4 (8.5%) group 2 patients had osteonecrosis of the femoral head (P = 0.531). Multivariate logistic regression showed that internal fixation by the fixed-angle fixation device decreased the odds ratio for overall complication by a factor of 0.23, for example, by 77% (P = 0.018).
  
  
  CONCLUSIONS
  Performing internal fixation by a fixed-angle fixation device decreased nonunion rates and revision rates. It did not affect the rate of osteonecrosis.
  
  
  METHODS
  Therapeutic level III. See instructions for authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopedic Surgery; and †Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Thein
authors.forename: Amir
authors.initials: A
authors.lastname: Herman
authors.forename: Paz
authors.initials: P
authors.lastname: Kedem
authors.forename: Aharon
authors.initials: A
authors.lastname: Chechik
authors.forename: Nachshon
authors.initials: N
authors.lastname: Shazar
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged