Comparison between three cannulated screws and targon locking plate for displaced intracapsular hip fracture: a retrospective study
Abstract
Purpose: The aim of this retrospective study was to compare the clinical and radiological outcomes between three cannulated screws (TCS) and a combination of two cannulated screws along with one fully threaded cannulated screw with a TARGON locking plate (TCS-TLP) for the treatment of displaced intracapsular hip fractures.
Methods: Seventy-five patients with displaced intracapsular hip fractures were treated surgically between January 2013 and January 2019. Thirty-five patients underwent TCS-TLP, while the remaining 40 patients were treated with TCS. Injuries were assessed according to the AO classification, and outcome measurements included the modified Harris hip score (MHHS), visual analogue score (VAS), and radiological data.
Results: The TCS-TLP group showed significantly better MHHS improvement than the TCS group at 12 months (85.6 vs. 75.6, P < 0.05) and 24 months (89.4 vs. 81.1, P < 0.05). Furthermore, the TCS-TLP group had a lower incidence of complications compared to the TCS group, with 5 patients experiencing complications in the TCS-TLP group versus 14 cases in the TCS group (P < 0.05). Similarly, the femoral neck shorten rate was significantly lower in the TCS-TLP group at each follow-up visit (P < 0.05).
Conclusion: Patients who are treated with a combination of two cannulated screws, including one fully threaded cannulated screw along with a TCS-TLP, can experience improved functional outcomes, reduced orthopedic complications, and prevention of femoral neck shortening.
Downloads
References
Alexiou KI, Roushias A, Varitimidis SE, Malizos KN. Quality of life and psychological consequences in elderly patients after a hip fracture: a review. Clin Interv Aging 2018; 13: 143–50. doi: 10.2147/CIA.S150067
Wang Y, Cui H, Zhang D, Zhang P. Hospitalisation cost analysis on hip fracture in China: a multicentre study among 73 tertiary hospitals. BMJ Open 2018; 8(4): e019147. doi: 10.1136/bmjopen-2017-019147
Beebe MJ, Bauer JM, Mir HR. Treatment of hip dislocations and associated injuries: current state of care. Orthop Clin North Am 2016; 47(3): 527–49. doi: 10.1016/j.ocl.2016.02.002
Chammout K, Mukka SS, Carlsson T, Neander GF, Helge Stark AW, Sköldenberg OG. Total hip replacement versus open reduction and internal fixation of displaced femoral neck fractures: a randomized long-term follow-up study. J Bone Joint Surg Am 2012; 94(21): 1921–8. doi: 10.2106/JBJS.K.01615
Bigoni M, Turati M, Leone G, Caminita AD, D’Angelo F, Munegato D, et al. Internal fixation of intracapsular femoral neck fractures in elderly patients: mortality and reoperation rate. Aging Clin Exp Res 2020; 32(6): 1173–8. doi: 10.1007/s40520-019-01237-z
Parker M, Cawley S, Palial V. Internal fixation of intracapsular fractures of the hip using a dynamic locking plate: two-year follow-up of 320 patients. Bone Joint J 2013; null(10): 1402–5. doi: 10.1302/0301-620X.95B10.31511
Mater HE, Chadran P. Outcomes of internal fixation of intracapsular hip fractures using dynamic locking plate system (Targon FN). J Orthopaedic 2018; 15(3): 829–31. doi: 10.1016/j.jor.2018.08.019
Li J, Zhao Z, Yin P, Zhang L, Tang P. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis. J Orthop Surg Res 2019; 14(1): 76. doi: 10.1186/s13018-019-1097-x
Weil YA, Qawasmi F, Liebergall M, Mosheiff R, Khoury A. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg 2018; 138(5): 661–7. doi: 10.1007/s00402-018-2896-y
Kanthasamy S, To K, Webb JI, Elbashir M, Parker MJ. Timing of surgery for internal fixation of intracapsular hip fractures and complications at 1 year; a 32 year clinical study of 2,366 patients at a single center. Injury. 2021; 53(2), 584–589. doi: 10.1016/j.injury.2021.11.038
Brokelman RB, Haverkamp D, van Loon C, Hol A, van Kampen A, Veth R. The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty. Eur Orthop Traumatol 2012; 3(2): 101–5. doi: 10.1007/s12570-012-0100-3
Vishwanathan K, Akbari K, Patel AJ. Is the modified Harris hip score valid and responsive instrument for outcome assessment in the Indian population with pertrochanteric fractures? J Orthop 2018; 15(1): 40–6. doi: 10.1016/j.jor.2017.12.001
Stockton DJ, Lefaivre KA, Deakin DE, Osterhoff G, Yamada A, Broekhuyse HM, et al. Incidence, magnitude, and predictors of shortening in young femoral neck fractures. J Orthop Trauma 2015; 29(9): e293–8. doi: 10.1097/BOT.0000000000000351
Liu Y, Al ZS, Shao J, Yang T. Femoral neck shortening after internal fixation. Acta Orthop Traumatol Turc 2013; 47(6): 400–4. doi: 10.3944/AOTT.2013.3235
Wani IH, Sharma S, Latoo I, Salaria AQ, Farooq M, Jan M. Primary total hip arthroplasty versus internal fixation in displaced fracture of femoral neck in sexa- and septuagenarians. J Orthop Traumatol 2014; 15(3): 209–14. doi: 10.1007/s10195-013-0278-3
Dong Q, Han Z, Zhang YG, Sun X, Ma XL. Comparison of transverse cancellous lag screw and ordinary cannulated screw fixations in treatment of vertical femoral neck fractures. Orthop Surg 2019; 11(4): 595–603. doi: 10.1111/os.12503
Parker M, Cawley S, Palial V. Internal fixation of intracapsular fractures of the hip using a dynamic locking plate: two-year follow-up of 320 patients. Bone Joint J 2013; 95-b(10): 1402–5. doi: 10.1302/0301-620X.95B10.31511
Li J, Zhao Z, Yin P, Zhang L, Tang P. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis. J Orthop Surg Res 2019; 14(1): 76. doi: 10.1186/s13018-019-1097-x
Boraiah S, Paul O, Hammoud S, Gardner MJ, Helfet DL, Lorich DG. Predictable healing of femoral neck fractures treated with intraoperative compression and length-stable implants. J Trauma 2010; 69(1): 142–7. doi: 10.1097/TA.0b013e3181bba236
Warschawski Y, Sharfman ZT, Berger O, Steinberg EL, Amar E, Snir N. Dynamic locking plate vs. simple cannulated screws for nondisplaced intracapsular hip fracture: a comparative study. Injury 2016; 47(2): 424–7. doi: 10.1016/j.injury.2015.10.054
Thein R, Herman A, Kedem P, Chechik A, Shazar N. Osteosynthesis of unstable intracapsular femoral neck fracture by dynamic locking plate or screw fixation: early results. J Orthop Trauma 2014; 28(2): 70–6. doi: 10.1097/BOT.0b013e3182a225fa
Tidermark J, Ponzer S, Svensson O, Soderqvist A, Tornkvist H. Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial. J Bone Joint Surg Br 2003; 85(3): 380–8. doi: 10.1302/0301-620X.85B3.13609
Wang Z, Yin Y, Li Q, Sun G, Peng X, Yin H, et al. Comparison of early complications between the use of a cannulated screw locking plate and multiple cancellous screws in the treatment of displaced intracapsular hip fractures in young adults: a randomized controlled clinical trial. J Orthop Surg Res 2018; 13(1): 201. doi: 10.1186/s13018-018-0901-3
Alves T, Neal JW, Weinhold PS, Dahners LE. Biomechanical comparison of 3 possible fixation strategies to resist femoral neck shortening after fracture. Orthopedics 2010; 33(4): 233–237. doi: 10.3928/01477447-20100225-07
Alshameeri Z, Elbashir M, Parker MJ. The outcome of intracapsular hip fracture fixation using the Targon Femoral Neck (TFN) locking plate system or cannulated cancellous screws: a comparative study involving 2004 patients. Injury 2017; 48(11): 2555–2562. doi: 10.1016/j.injury.2017.08.063
Copyright (c) 2023 Xiuxiu Hou, Guojun Shi, Yadi Zhang, Baoheng Xing, Dingli Xu

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain full copyright to their individual works, and publishing rights without restrictions.
In accordance with the Budapest Open Access Initiative, articles published in STEMedicine are freely available "on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited."
Except where otherwise noted, all content on this website is licensed under a Creative Commons Attribution 4.0 License. This license allows for commercial and non-commercial redistribution as well as modifications of the work as long as attribution is given to the authors and STEMedicine as the original publication source, and a link to the article on the STEMedicine website is provided.