RIGID OSTEOSYNTHESIS DECREASES THE LATE COMPLICATION RATE AFTER FEMORAL-NECK FRACTURE - THE INFLUENCE OF 3 DIFFERENT OSTEOSYNTHESIS DEVICESEVALUATED IN 369 PATIENTS

The influence of threee different fixation devices on late healing com plications after femoral neck fractures was studied in a large patient group from three different hospitals. Except for the choice of device , which was unique to each hospital, all other factors having a potent ial influence on the late outcome, such as sex and age of the patients , initial degree of fracture dislocation and quality of surgical reduc tion were similar among the three groups. Within a 2-year observation period the incidence of late segmental collapses (14%-19%) was not rel ated to choice of device, but a higher number of non-unions (27%-30%) occurred after adaptive non-rigid methods using screws (von Bahr) or a flanged nail (Rydell) than after a more rigid osteosynthesis (8%, Dey erle), Using such a rigid fixation, the complication rate could be red uced by one-third and the need for revision surgery halved. A device p roviding stable fixation should be preferred for treatment of femoral neck fractures in the elderly to prevent the healing complications rel ated to insufficient stabilization.