ABSTRACT
Background: Basicervical fracture is a fracture through the base of femoral neck at its junction with the intertrochanteric region. Due to this location, it represents an intermediate form between femoral neck, usually fixed with multiple cancellous screws, and the intertrochanteric fracture, fixed with a sliding screw device. Previous studies recommended treating basicervical fractures as intertrochanteric fractures with the dynamic hip screw (DHS). However, because basicervical fractures have greater instability than stable intertrochanteric fractures, poor functional outcome may be expected when the DHS used alone. Aims & Objective: To evaluate the outcome of fixation of basicervical and related fractures using DHS with DRS. Materials and Methods: We prospectively studied 42 patients in order to identify a group of proximal femoral fractures having liability for axial and rotational instability, and to present results of their fixation using the dynamic hip screw (DHS) with derotation screw (DRS). Results: At 12 months postoperatively, patients were functionally evaluated and the radiological outcome was analysed. All fractures united within an average period of 11.5 weeks. The mean sliding distance was 5.5 mm and mean shortening of the limbs was 2 mm. According to the criteria of Kyle et al. (J Bone Joint Surg [Am] 61-A:216–221), 39 patients obtained excellent results, two good and one fair. Conclusion: We conclude that the AO types B2.1, A1.1, A2.1, A2.2 and A2.3 have a common instability denominator and therefore should be treated alike. The sliding component of the DHS allows solid fixation of the two major fragments in two planes and the DRS in the third plane.