Fracture neck of femur has always attracted the mankind due to its peculiar nature of going into non union and osteonecrosis of femoral head even with best fixation method and adequate reduction. A novel way to treat fracture neck of femur is with small diameter dynamic hip screw and an additional derotation screw. 30 patients aged 18-60 years presenting to Deen Dayal Upadhyay Hospital with fresh (<3 weeks old) fracture neck of femur were randomized into two groups and were treated with two different modalities of fixation: Small diameter sliding hip screw and plate with an additional derotation screw (Mini DHS group) and three cannulated cancellous screws in an inverted triangle configuration (CCS group). Intraoperative duration of surgery and blood loss was noted. All the patients were followed up for a minimum period of 12 months. The clinical outcomes were evaluated using UCLA score. Post-operative radiographs were used to look for evidence of union, loss of the alignment of the fracture, trabecular continuity at fracture line, late segmental collapse and the presence of avascular necrosis. Between group comparisons were performed using chi square test and Student’s T test.
Conclusion: Small diameter dynamic hip screw with an additional derotation screw is a good method to treat fracture neck of femur with increased incidence of union and less complications.