Clinical outcome of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patients

Shibao Lu,Jingbo Cheng,Zhihua Gao,Huaijian Hu,Mingli Feng,Jingwei Wu

doi:10.1186/s13018-021-02517-z

Shibao Lu, Jingbo Cheng + Show 4 more

Open Access

https://doi.org/10.1186/s13018-021-02517-z

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Abstract

BackgroundThe clinical outcome of a new fixation device (femoral neck system, FNS) for femoral neck fractures remains unclear. The main purpose of this study was to evaluate two different internal fixation methods for the treatment of femoral neck fractures in patients aged under 60 years.MethodsWe retrospectively studied patients who underwent internal fixation surgery in our hospital for femoral neck fractures between January 2017 and January 2020. Cannulated compression screws (CCS) and FNS groups were divided according to different internal fixation methods. General data (such as sex, age, body mass index, type of fracture) of all patienFemoral neck shorteningts were collected, and joint function was evaluated using the Harris Hip Score (HHS) before and 1 year after surgery. We recorded related surgical complications, including femoral head necrosis, nonunion, and femoral neck shortening.ResultsThere were no significant differences in age, sex, or body mass index between the two groups. There was no statistical difference in HHSs between the two groups before surgery. Patients who underwent FNS treatment had longer surgery time (79.75 ± 26.35 min vs. 64.58 ± 18.56 min, p = 0.031) and more blood loss (69.45 ± 50.47 mL vs. 23.71 ± 28.13 mL, p < 0.001). The degree of femoral neck shortening in the FNS group was significantly lower than that in the CCS group (10.0% vs 37.5%, p = 0.036). Regarding postoperative complications, there was no statistical difference in the incidence of femoral head necrosis and fracture nonunion between the two groups.ConclusionPatients younger than 60 with femoral neck fractures can obtain satisfactory clinical results with CCS or FNS treatment. FNS has excellent biomechanical properties and shows significantly higher overall construct stability.

Highlights

The clinical outcome of a new fixation device for femoral neck fractures remains unclear
According to different internal fixation methods, they were divided into the femoral neck system (FNS) and compression screws (CCS) groups
Regarding the classification of Femoral neck fracture (FNF), most patients are classified as Garden type III or type IV

Summary

Introduction

The clinical outcome of a new fixation device (femoral neck system, FNS) for femoral neck fractures remains unclear. The main purpose of this study was to evaluate two different internal fixation methods for the treatment of femoral neck fractures in patients aged under 60 years. Femoral neck fractures (FNFs) are a common injury in orthopedic practice and result in significant morbidity and mortality [1]. FNFs are most common in the elderly population, but the treatment of FNFs in relatively young patients deserves our attention. Fractures of the femoral neck are usually caused by high-energy trauma, such as falls from high places or high-speed traffic accidents [2]. The goal of surgical treatment is to retain the femoral head as much as possible, avoid necrosis of the femoral head, and achieve bone healing. Young patients with FNFs prefer open or closed reduction and internal fixation (CRIF) [2, 3]. Anatomical reduction and effective fixation are essential for obtaining good prognosis and function [4]

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