[The minimally-invasive screw osteosynthesis of the medial femoral neck fracture in the very old. A prospective clinical study].

Increasing life expectancy has led to an increase of medial femoral neck fractures. Treatment by hip arthroplasty is a major surgical procedure for geriatric patients and imposes high healthcare costs. Manninger developed a cannulated screw system which allows a joint-sparing, less invasive, and stable internal fixation for the management of intracapsular femoral neck fractures. In a prospective study from January 1998 to August 2002, 63 patients older than 70 years with Garden type I to III fractures were treated by closed reduction and internal fixation with two Manninger screws on a traction table within the first 6 h after trauma. Mean time of follow-up was 21.5+/-16 months. Of the patients examined, 88.5% regained their preoperative stage of mobility. Two patients needed secondary hip arthroplasty. Due to low complication and failure rates and less medical expenses compared to treatment by hemiprosthesis the joint-sparing, less invasive internal fixation with two cannulated Manninger screws presents a safe and cost-efficient surgical technique for geriatric patients.