Internal fixation of intracapsular fractures of the hip using a dynamic locking plate: Two-year follow-up of 320 patients

Bone Joint J. 2013 Oct;95-B(10):1402-5. doi: 10.1302/0301-620X.95B10.31511.

Abstract

A consecutive series of 320 patients with an intracapsular fracture of the hip treated with a dynamic locking plate (Targon Femoral Neck (TFN)) were reviewed. All surviving patients were followed for a minimum of two years. During the follow-up period 109 patients died. There were 112 undisplaced fractures, of which three (2.7%) developed nonunion or re-displacement and five (4.5%) developed avascular necrosis of the femoral head. Revision to an arthroplasty was required for five patients (4.5%). A further six patients (5.4%) had elective removal of the plate and screws. There were 208 displaced fractures, of which 32 (15.4%) developed nonunion or re-displacement and 23 (11.1%) developed avascular necrosis. A further four patients (1.9%) developed a secondary fracture around the TFN. Revision to a hip replacement was required for 43 patients (20.7%) patients and a further seven (3.3%) had elective removal of the plate and screws. It is suggested that the stronger distal fixation combined with rotational stability may lead to a reduced incidence of complications related to the healing of the fracture when compared with other contemporary fixation devices but this needs to be confirmed in further studies.

Keywords: Dynamic locking plate; Hip; Hip fracture; Internal fixation; Intracapsular hip fracture; Trauma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip
  • Bone Plates*
  • Female
  • Femoral Neck Fractures / complications
  • Femoral Neck Fractures / diagnostic imaging
  • Femoral Neck Fractures / surgery*
  • Femur Head Necrosis / etiology
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods
  • Fracture Fixation, Internal / rehabilitation
  • Fracture Healing
  • Fractures, Ununited / etiology
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Prosthesis Design
  • Radiography
  • Recovery of Function
  • Reoperation
  • Treatment Outcome
  • Young Adult