Lag screw with DHS (LSD) for vertical angle femoral neck fractures in young adults

Vertical Pauwels Type III fractures of the neck of femur in young patients are difficult fractures to treat. These are usually as a result of high energy trauma which are associated with a significant degree of fracture comminution in the neck of femur. This makes the fracture reduction and fixation difficult. Many fixation methods and implants have been described for use in these fractures but are not without reported complications such as non-union and varus collapse. In this article, we highlight the incidence of fracture comminution in both the anterior and posterior cortices of the femoral neck, better visualised with axial computed tomography scanning and describe a simple technique utilizing lag screws and a DHS implant to adequately address these fractures.