The Dynamic Martin Screw: an Alternative for Intracapsular Femoral Neck Fractures?

The aim of this study was to determine whether the fixation device known as the dynamic Martin screw (DMS) offers a reasonable alternative for stabilizing intracapsular femoral neck fractures.

A total of 63 patients with intracapsular femoral neck fractures, stabilized between 1993 and 1997 with the DMS, were followed up in this retrospective study in both 1999 and 2002. The patients were on average 64 years of age, with 30 younger and 33 older than 65. The main outcome measurements consisted of union, non-union, aseptic osteonecrosis of the femoral head and implant failure.

We determined an overall osteonecrosis rate of 19% (12 of 63) for our patient group after an observation period on average of 83 months. The osteonecrosis rate for undisplaced fractures was 13.2% (5 of 38), and 28% (7 of 25) for displaced fractures. Non-union occurred in 4.8% (3 of 63) and union in 95.2% (60 of 63) of the patient cases. An implant-associated complication involving deep infection occurred in one case, but no example of implant breakage was recorded.

As a method for stabilizing intracapsular femoral neck fractures, the DMS provides treatment results comparable to other sliding hip screws or cannulated screw.