Pearls and Pitfalls of Cannulated Cancellous Screw Fixation for Fracture Neck of Femur

Aims and Objective: The present study was done at P. M. C. H, Patna during the period of 15th July, 2013 to 15th July, 2018 to see the pearls and pitfalls of Cannulated Cancellous Screw fixation for fracture neck of femur. Materials and Methods: 30 cases of fracture neck of femur of age group 15-60 years admitted at P. M. C. H, Patna and operated with C. C. S fixation were analysed retrospectively. Observation: 22 out of 30 cases i. e. (73.33%) fixed with C. C. S (properly placed and aligned screws) and adequate interfragmentary compression showed good surgical outcomes and achieved bony union at acceptable time. 8 out of 30 cases i. e. (26.67%) were grouped into failure cases. Improper C. C. S fixation and inadequate interfragmentary compression were found to be the causative factor in 7 of the 8 cases i. e. (87.5% of failed cases). All 8 cases underwent additional surgeries in post-operative period. In 4 out of 8 cases i. e. (50%) underwent Pauwel?s osteotomy with D. H. S fixation, C. C. S fixation with non-vascularised fibular graft was done in 3 out of 8 cases i. e. (37.5%) and D. H. S fixation with muscle pedicle bone graft was done in 1 out of 8 cases i. e. (12.5%).3 out of 8 failed i. e. (37.5%) cases developed AVN in late stage for which T. H. R was done. Conclusion: In our opinion success rate of Cannulated Cancellous Screw fixation for fractures of neck of femur can significantly be increased by proper and aligned screw fixation and adequate interfragmentary compression of the fracture fragments.