Dynamic Locking Plate versus Multiple Cancellous Screws for the Fixation of Intracapsular Femoral Neck Fractures: Long-Term Results and Prom Based Quality of Life Assessment

The purpose of this study was to compare the long-term clinical outcomes and quality of life measures for two fixation methods in the setting of displaced femoral neck fractures. The two groups included fixation with multiple cancellous screws (group 1) and telescopic femoral neck screws and small locking plate device (Targon FN) (group 2). Patients underwent reduction and internal fixation with either multiple cancellous screws or Targon FN device from March 2000 to January 2012. Failure endpoints included nonunion, osteonecrosis of the femoral head, and revision surgery. Patient reported outcome measures included chronic pain, ability to ambulate, and the use of ambulation assistive devices. Statistical analysis demonstrated a statistically significant lower rate of non-union and overall complication in the Targon FN group (p value < 0.001 and p value = 0.005 respectively). Logistic regression analysis showed that operative fixation with the Targon FN device decreased the odds ratio for overall complication by a factor of 0.34 (P = 0.02). There were no statistically significant differences between groups 1 and 2 in patient reported outcomes (chronic pain (p-0.21), ability to ambulate (p- 0.07), and the use of ambulation assistive device (p-0.07)). When compared to traditional cancellous screw fixation of femoral neck fractures, the Targon FN device has significantly lower complications rates and equivalent patient reported outcomes.