Comparison of Total hip arthoplasty and DHS with Bone graft for Neck of femur fractures in terms of mobility and patient satisfaction.
1Dr Muhammad Inam, 2Dr Muhammad Asim Munir Qureshi, 3Dr Rizwan Anwar, 4Dr Tabbsum Raja, 5Dr Danish Marwat, 6Dr Adnan Jahangir
Submission: 17 February 2026 | Acceptance: 19 March 2026 | Publication: 14 April 2026,
1Associate Professor of Orthopedics Medical Teaching Institute Lady Reading Hospital Peshawar Pakistan
2Senior registrar lahore general hospital lahore
3Associate professor Orthopedic surgery Islam medical college Sialkot
4Service Hospital, Lahore
5PIMS, Islamabad
6UHS, Lahore
Abstract
Background
Femur neck fractures are a common orthopedic injury that can cause serious morbidity, especially in older people. Although Total Hip Arthroplasty (THA) and Dynamic Hip Screw (DHS) with bone grafting are common therapeutic choices, the best surgical care is still debatable. The purpose of this study was to examine the postoperative mobility and patient satisfaction of these two modalities.
Objective
To assess and contrast the results of Dynamic Hip Screw with bone grafting and Total Hip Arthroplasty in patients with femur neck fractures, with an emphasis on patient satisfaction and mobility.
Methodology
Over the course of a year, 80 patients with femur neck fractures participated in this prospective observational study. Patients were split into two groups: Group B (n = 40) received Dynamic Hip Screw with bone grafting, while Group A (n = 40) had Total Hip Arthroplasty. At six weeks, three months, and six months, patients were monitored. The Harris Hip Score was used to measure mobility, and a standardized questionnaire was used to gauge patient satisfaction. Appropriate tests were used for statistical analysis, and a p-value of less than 0.05 was deemed significant.
Results
The THA group had a considerably higher mean Harris Hip Score (88.5 ± 6.3) than the DHS group (78.2 ± 8.7) (p < 0.05). In contrast to 60% of patients in the DHS group, 80% of patients in the THA group showed excellent to good mobility outcomes. Compared to 35% in the DHS group, a larger percentage of patients in the THA group (60%) expressed high levels of satisfaction. Complications include non-union (12.5%), avascular necrosis (10%), and implant failure (15%) were more common in DHS with bone grafting than in THA, which had a reduced complication rate but a slight risk of dislocation (7.5%).
Conclusion
When treating femur neck fractures, total hip arthroplasty yields better functional results and more patient satisfaction than dynamic hip screws with bone grafting. While DHS with bone grafting is still an option for certain younger individuals, it is advised as the ideal treatment, especially for older patients.
Keywords
Femoral neck fracture; Total Hip Arthroplasty; Dynamic Hip Screw; Bone grafting; Mobility; Harris Hip Score; Patient satisfaction; Orthopedic surgery