Title : An audit to review functional outcomes and complications of Dynamic Hip Screws (DHS) fixation and Intra Medullary Nail (IMN) for Neck of Femur Fractures (NoFF) at Royal Blackburn Hospital
Abstract:
Background: Neck of Femur Fractures (NoFF) are among the most common fractures in the UK, with over 70,000 cases reported annually. NOFF are associated with significant morbidity and mortality. Dynamic Hip Screws (DHS) and Intra Medullary Nails (IMN) remain the mainstay treatment, but variations in outcomes continue to be reported.
Aim: This audit evaluated surgical outcomes and adherence of DHS and IMN surgeries performed at Royal Blackburn Hospital (RBH) to National Institute for Health and Care Excellence (NICE) and National Hip Fracture Database guidelines during 2023–2024. The primary focus is on failure rates and complications.
Methods: A retrospective cohort study was conducted on 417 patients aged 18 and above who underwent either DHS or IM nail fixation for NoFF at RBH in 2023- 2024. Data was extracted from electronic patient records. Statistical analysis was performed using the Chi-squared test in SPSS.
Results: Of the 417 patients, 317 underwent DHS and 100 received IMN (268 females, 151 males). Failure rates were 3.47% for DHS and 1.00% for IMN (p < 0.001). Blood transfusion was required in 10.16% of DHS cases and 30.39% of IMN cases (p < 0.001). Mortality rates were similar (20.32% vs 20.59%, p = < 0.001), while consultant presence was significantly higher in IMN cases (74.42%) compared to DHS (34.87%) (p < 0.01).
Conclusion: The data suggest IMN had a lower failure rate than DHS; however, IMN had higher blood transfusion rates. Mortality outcomes were similar between the groups. Higher consultant presence in IMN procedures reflects the complexity of these cases. These findings suggest that IMN offers advantages but carries greater perioperative risks. Increased consultant supervision and adherence to guidelines are recommended to improve outcomes.
Disclosure: There are no conflicts of interest to declare. The audit received support from clinical staff at Royal Blackburn Hospital, and data was collected under institutional approval.
