Hip & pelvis · 2026
Similar Outcomes for Fixation of Undisplaced Intracapsular Hip Fractures with Either Cannulated Screws or Dynamic Hip Screws in 255 Patients: A Comparison of Propensity-Matched Groups.
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Shardlow Benjamin, Nocun Weronika, Khater Abdul, Nightingale Jessica, Gordon Catherine, Norrish Alan
Аннотация
PURPOSE: Internal fixation of undisplaced intracapsular hip fractures is typically achieved using either cannulated screws (CS) or a 2-hole dynamic hip screw (DHS). However, there is a lack of consensus on which of these is more effective clinically. Whilst several biomechanical analyses of cadaveric hips show a higher construct stability of DHS fixation, there is a paucity of large clinical studies investigating patient outcomes.
MATERIALS AND METHODS: Data from 2,705 patients at a single institution, including 322 internal fixations, were analysed retrospectively. Propensity scores were calculated to mitigate for the impact of covariates such as age, sex, Charlson comorbidity index and Nottingham Hip Fracture Score, producing an eligible group of 255 patients.
RESULTS: The CS group included 204 patients (mean age, 82.5±7.5 years; female, 90.7%), the DHS group included 51 patients (mean age, 82.4±8.0 years; female, 90.2%). There were no differences between groups after propensity matching. There were no significant differences in outcomes between CS and DHS groups for reoperation rate (CS 5.9% vs. DHS 5.9%, P>0.999), death <30 days (CS 5.9% vs. DHS 5.9%, P>0.999), length of stay (CS 11.5 days vs. DHS 14.0 days, P=0.294) and hours to surgery (CS 31:03 hours vs. DHS 29:23 hours, P=0.618). However, operation time was significantly shorter for CS (CS 39.0 minutes vs. DHS 44.0 minutes, P=0.013), an 11% reduction.
CONCLUSION: There is no difference in clinical outcomes between CS and DHS fixation of intracapsular hip fractures. However, in this cohort the operating time was approximately 5 minutes shorter in CS fixation.
MATERIALS AND METHODS: Data from 2,705 patients at a single institution, including 322 internal fixations, were analysed retrospectively. Propensity scores were calculated to mitigate for the impact of covariates such as age, sex, Charlson comorbidity index and Nottingham Hip Fracture Score, producing an eligible group of 255 patients.
RESULTS: The CS group included 204 patients (mean age, 82.5±7.5 years; female, 90.7%), the DHS group included 51 patients (mean age, 82.4±8.0 years; female, 90.2%). There were no differences between groups after propensity matching. There were no significant differences in outcomes between CS and DHS groups for reoperation rate (CS 5.9% vs. DHS 5.9%, P>0.999), death <30 days (CS 5.9% vs. DHS 5.9%, P>0.999), length of stay (CS 11.5 days vs. DHS 14.0 days, P=0.294) and hours to surgery (CS 31:03 hours vs. DHS 29:23 hours, P=0.618). However, operation time was significantly shorter for CS (CS 39.0 minutes vs. DHS 44.0 minutes, P=0.013), an 11% reduction.
CONCLUSION: There is no difference in clinical outcomes between CS and DHS fixation of intracapsular hip fractures. However, in this cohort the operating time was approximately 5 minutes shorter in CS fixation.