Incidence and Patterns of Postoperative Complications Following Biplane Double-Supported Screw Fixation in Femoral Neck Fractures: A Cross-Sectional Analysis

Open Access

Abstract

Background: Femoral neck fractures pose a substantial difficulty in orthopedic trauma, especially in younger patients, when preserving the femoral head is critical. The purpose of this study was to assess the incidence and patterns of postoperative problems associated with BDSF in femoral neck fractures. Methods & Materials: This cross-sectional study was carried out at the National Institute of Traumatology and Orthopedic Rehabilitation in Dhaka from July 2018 to June 2020. 50 adult patients with acute traumatic femoral neck fractures (Garden Types I-III) who presented within 14 days of injury received BDSF with three 6.5-mm cannulated screws in a biplane configuration. Patients were monitored for 25.8 ± 2.4 weeks. The primary outcomes were radiological union time and postoperative complications. The Harris Hip Score was used to assess functional results. Data were entered and analyzed using SPSS version 26. Results: The mean patient age was 43.2±15.4 years, with a male majority (62%). Motor vehicle accidents caused 84% of injuries. Radiological union occurred at 18.4±4.2 weeks. The overall complication rate was 28%, which included wound infection (10%), delayed union (8%), nonunion (4%), deep vein thrombosis (2%), avascular necrosis (2%), and implant failure. The average HHS at final follow-up was 85.9±10.9, with 74% obtaining good-to-excellent results. Multivariate analysis revealed that increasing age (OR=1.06, p=0.029), Garden Type III fractures (OR=4.75, p=0.043), and union duration of more than 18 weeks (OR=6.40, p=0.005) were independent predictors of problems. Conclusion: BDSF has manageable complication rates and satisfactory functional outcomes in femoral neck fractures. Advanced Garden categorization, rising age, and delayed union all predict surgical problems, necessitating increased monitoring in high-risk patients.