Methods of fixation used in management of femoral neck fractures in adults: a systematic review

Abstract

Background: Femoral neck fractures in adults younger than 50 yr old are uncommon and often result from high-energy trauma. They account for only 2-3% of all femoral neck fractures. Femoral neck fractures in young adults are associated with a high incidence of femoral head osteonecrosis and nonunion. Dynamic hip screw, multiple cannulated screws, and a Targon® femoral neck (TFN) plate can be used in management. A systematic review of the literature was done to evaluate which technique is best. Methods: After literature search, 11 articles were found and were reviewed to evaluate final outcome of fixation of femoral neck fractures using dynamic hip screw, multiple cannulated screws, or a TFN plate. Results: After evaluation of all studies, the incidence of nonunion, osteonecrosis of the femoral head, implant failure, and reoperation were almost equal in both dynamic hip screw and TFN plate groups, while it was much higher in the patient group fixed with multiple cannulated screws. Conclusions: Dynamic hip screw fixation had a low incidence of complications in the final outcome when compared with multiple cannulated screws. Further study was needed for application of the TFN plate.