Treatment of subcapital femoral neck fractures with bioabsorbable or metallic screw fixation - A preliminary report

Background and Aims: Cancellous bone fractures and arthrodeses have been tr eated successfully with bioabsorbable polyglycolide and poly-L-lactide impl ants. In this study bioabsorbable poly-L-lactide lag screws and metallic sc rews were compared in the fixation of subcapital femoral neck fractures. Patients and Methods: Forty patients with femoral neck fractures were treat ed by internal fixation using three bioabsorbable self-reinforced poly-L-la ctide (SR-PLLA) lag screws of 6.3 mm in diameter and 38 patients using thre e metallic screws of 7 mm in diameter. In addition, one patient was operate d on using two and one using four metallic screws. The patients did not dif fer in age, body weight or primary dislocation of the fracture. There were six males in the lactide group versus 14 in the metallic fixation group. Th ere were two Garden Stage I, 27 Garden Stage II, nine Garden Stage III, and two Garden Stage IV fractures in both groups. Results: In the Garden I and II fractures there were 5/29 redislocations af ter SR-PLLA fixation and 8/29 after metallic fixation. In the Garden III fr actures there were 4/9 and in the Garden IV fractures 2/2 redislocations in both groups. The ability to walk and the range of movement were better aft er bioabsorbable fixation. Conclusion: Self-reinforced poly-L-lactide lag screws can be used safely to fix subcapital femoral neck fractures in Garden Stage I and II fractures a nd in younger patients in Garden III fractures.