title: Fixed angle devices versus multiple cancellous screws: what does the evidence tell us?
abstract: Complications, including nonunion and avascular necrosis, are relatively common after internal fixation of a femoral neck fracture. Young patients are particularly impacted by these complications as salvage options often result in a suboptimal functional result. The quality of reduction appears to be of primary importance; however, it is unknown whether the choice of internal fixation affects the incidence of complications. In this article, we present the rationale and evidence for available internal fixation options. Current evidence is insufficient to recommend an optimal method of internal fixation, and this review demonstrates the need for high-quality randomised, controlled trials to study this problem.
authors: Department of Orthopaedics, Harbor-UCLA Medical Center, 1000 W. Carson St, Box 422, Torrance, CA 90509, United States. Electronic address: hoshinomax@gmail.com.
authors: C Max
authors: CM
authors: Hoshino
authors: Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene St, T3R62, Baltimore, MD 21201, United States.
authors: Robert V
authors: RV
authors: O'Toole
mesh_terms: D000367:Age Factors; D001863:Bone Screws; D019317:Evidence-Based Medicine; D005265:Femoral Neck Fractures / Q000601:surgery*; D005271:Femur Head Necrosis / Q000209:etiology / Q000473:pathology*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D005599:Fractures, Ununited / Q000209:etiology / Q000473:pathology*; D006801:Humans
keywords: Avascular necrosis; Femoral neck fracture; Fixed angle device; Hip fracture; Internal fixation; Multiple cancellous screws; Nonunion