Comparison of short-term efficacy between femoral neck system and cannulated compression screws in treatment of femoral neck fractures / 中华创伤骨科杂志

ABSTRACT

Objective:To compare the short-term efficacy between femoral neck system (FNS) and cannulated compression screws (CCS) in the treatment of femoral neck fractures in young and middle-aged patients.Methods:A retrospective study was performed of the 29 young and middle-aged patients with femoral neck fracture who had been treated with FNS at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2020 to December 2020. A control group of another 29 patients with femoral neck fracture was selected who had been treated with CCS but matched in gender, age, and body mass index. In the CCS group, there were 14 males and 15 females with an age of (48.2±12.3) years; in the FNS group, there were 14 males and 15 females with an age of (48.2±12.0) years. The fracture reduction quality, operation time, intraoperative blood loss, and femoral neck shortening, hip joint function, Barthel index and health survey 12-item short form (SF-12) score at the last follow-up and complications during follow-up were compared between the 2 groups.Results:No significant difference was found in the preoperative general data or follow-up time between the 2 groups, showing comparability ( P>0.05). The intraoperative blood loss in the CCS group [20 (10, 50) mL] was significantly less than that in the FNS group [50 (20, 50) mL], and the femoral neck shortening at the last follow-up in the CCS group (grade 1 in 5 cases; grade 2 in 18 cases and grade 3 in 6 cases) was significantly worse than that in the FNS group (grade 1 in 21 cases, grade 2 in 6 cases and grade 3 in 2 cases) ( P<0.05). No significant difference was found regarding fracture reduction quality, operation time, complications during follow-up, or Merle D'Aubigne Postel score, Barthel index or SF-12 score at the last follow-up ( P>0.05). Conclusions:In the treatment of femoral neck fractures in young and middle-aged patients, both FNS and CCS are good options for internal fixation. However, FNS can reduce the severity of femoral neck shortening and maintain the length of femoral neck better than CCS.