title: A comparative study between multiple cannulated screws and dynamic hip screw for fixation of femoral neck fracture in adults.
abstract: OBJECTIVE
  In younger adults with fractures of the femoral neck, anatomic reduction is compulsory and maintaining the reduction is crucial. Both cannulated screws and dynamic hip screw (DHS) have the capacity of compression in the fracture site but the strength for keeping reduction is not the same. The aim of this study was to compare the results with fixations of the femoral neck fractures with cannulated screws versus dynamic hip screw.
  
  
  METHODS
  This is a randomized clinical trial study on 58 cases with a minimum of one year follow-up. Leg length discrepancy, Harris Hip Score, infection, avascular necrosis of femoral head, and union of the fracture site were evaluated.
  
  
  RESULTS
  There were two failures in the first trimester in the cannulated screw group and three more failures in the second and third trimesters in this group. In the DHS group, there was no reduction and fixation failure in the follow-up period. There was no fixation failure (0 %) in Group B (DHS) but there were five fixation failures (18 %) in Group A (screw), and there is significant difference between the groups (p < 0.001). The rate of avascular necrosis was the same in both groups.
  
  
  CONCLUSIONS
  It seems to us that in our practice the fixation of femoral neck fracture in young adults with the DHS is a better option compared with the osteosynthsis with multiple cannulated screws.
authors.affiliation: Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran. siavashi@tums.ac.ir.
authors.forename: Babak
authors.initials: B
authors.lastname: Siavashi
authors.affiliation: Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Aalirezaei
authors.affiliation: Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mersad
authors.initials: M
authors.lastname: Moosavi
authors.affiliation: Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Golbakhsh
authors.affiliation: Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Dariush
authors.initials: D
authors.lastname: Savadkoohi
authors.affiliation: Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Zehtab
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Cannulated screw; Dynamic hip screw; Fracture; Neck of femur