Thesis (M.Sc.)-Cairo University, 2023.

Bibliography: pages 114-132.

Background: In the young patient with a displaced femoral neck fracture, the goals of treatment are to achieve anatomic reduction and stable internal fixation in the absence of osteonecrosis while preserving hip anatomy. In contrast to the elderly patient who might benefit from prosthetic replacement, in young patients, these goals are best met with internal fixation. Anatomic reduction is critical to promote and maintain femoral head vascularity and to achieve osseous union.
Implants for internal fixation of femoral neck fractures in physiologically young patients can be divided into 3 groups: multiple cancellous screws, fixed angle devices that allow sliding/compression, and fixed angle devices that do not allow for sliding/compression.
Aim: The purpose of this study was to assess the results of fixation of intracapsular femoral neck fractures in adults below age of 50 years by Fixed Angle Device (DHS with anti-rotation screw).
Materials and methods: A prospective study of 20 cases with neck femur fracture treated with Fixed Angle Device (DHS with anti-rotation screw).
Exclusion criteria were patients with pathologic fracture, skeletally immature patients, fracture more than one week since the fracture event, associated head or acetabulum fracture, rheumatoid arthritis, osteoarthritis, metabolic diseases, and Avascular necrosis hip.
Functional outcome was assessed using Harris Hip Score at 6 and 12 months.
Results: 20 cases were available for final follow-up, 9 cases (45%) were of Garden Type IV, 9 cases of (45%) of Garden Type III, 1 case (5%) of Garden Type II and 1 case (5%) of Garden Type I. 10 cases Pauwels Type III, 9 cases Pauwels Type II and 1 cases was Pauwels Type I. Mean age at presentation was 26.5 ± 8.33 years. Closed reduction was successful in achieving adequate reduction in all the cases. Union was achieved in 19 cases (95%). The mean follow-up period was 16 months with a minimum of 12 months for all patients included.
Mean Harris hip score at 6 months’ follow-up 84.16 with a standard deviation ±7.78 and at 12 months’ follow-up 91.37 with a standard deviation ±7.31.
Conclusion: Biomechanically, DHS represents a more stable construct, provides better compression at fracture site during time of fixation and gives better functional outcome in fracture neck of femur especially in displaced (Garden III and IV), more comminuted, and vertical (Pauwels classification III) fractures in comparison to other methods of fixation

ان كسور عنق عظمة الفخذ عند شباب البالغين تمثل مشكله غير محلوله و تحدى كبير . لهذا فان تثبيت هذة الكسور فى وضع تشريحى مثالى ضرورى لتجنب المضاعفات التى تحدث من عدم التئام او انقطاع الامداد الدموى عن رأس عظمة الفخذ .
وسائل تثبيت كسور عنق عظمة الفخذ عند البالغين تنقسم الى ثلاثه مجموعات : مسامير مجوفة متعددة، وسائل تثبيت ذات زاوية ثابتة تسمح بالانضغاط والانزلاق ، وسائل تثبيت ذات زاوية ثابتة لا تسمح بالانضغاط والانزلاق . فى الفترة ما بين اغسطس 2021 و حتى ابريل 2023 تم اجراء دراسة تحليلية لدراسة نتائج استخدام مسمارالفخذ اليناميكى ذو الشريحة الجانبية مع وضع مسمار مانع للدوران ، تم اجراء الدراسة على عدد عشرين مريض يعانون من كسرعنق عظمة الفخذ حيث تم فحصهم واجراء كافة الفحوصات والاشاعات اللازمة لتشخيصهم وتم تدوين كافة البيانات للحالات المرضية ، وتم متابعة الحالات لمدة لا تقل عن 12 شهرا لتقييم نتائج الجراحة

Issues also as CD.

Text in English and abstract in Arabic & English.