Abstract
Introduction
The aim of the study was to analyze the outcome of AO cannulated screws for fractures neck of femur at our institute.
Methods
412 patients (101 males/311 females) who underwent AO screws for fracture neck of femur over 5 years (2000 -2004) and followed-up for a minimum of 2 yrs formed the study population. A retrospective review of data from electronic patient record (EPR), clinical coding, clinic and GP letters was made. Age, residential placement, Garden's classification, mode of injury, associated comorbidities, pre-admission mobilisation status, allergies, addictions and anticoagulation status details were collected. Reasons for re-admissions, re-operations and comorbidities developing as a result of these interventions were critically analysed. Post-op physiotherapy, proportion of patients sustaining contra-lateral fracture NOF and its management and mortality statistics were reviewed.
Results
The mean age of patients was 68 yrs (range 18-96 yrs). Mean length of stay in hospital was 12.3 days (range2- 51 days) and mean time to operate from admission was 51 hrs (median 24 hrs). Second Surgery in form of hemiarthroplasty was required in 36, DHS in 7, Implant removal in 15 and Total hip replacement in 29 patients. Non-union occurred in 25 pts (7.93%)and avascular necrosis (AVN) in 61 Pts (19.36%) and overall 2 years mortality rate was 66 pts(16%)
Conclusion
AVN and Non union was high in patients with displaced fractures, patients more than 80 yrs and patients with co-morbidities like Renal Failure, Diabetes Mellitus, Osteoporosis and Steroid intake etc. Outcome is influenced by complex interplay of multiple factors so we should treat the physiological age and not the chronological age.
