Femoral neck system- an alternative for treatment of femoral neck fractures in adults

Femoral neck fractures improves hip functional recovery and reduces the femoral neck shortening rate and fluoroscopy exposure postoperatively. Thus, femoral neck system can be an alternative to inverted cannulated cancellous screws (ICCS) for the treatment of femoral neck fractures, finds a study, as published in the Journal of Orthopaedic Surgery and Research.

Yunfeng Tang and colleagues from the Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, People's Republic of China aimed to compare the clinical efficacy and complications of femoral neck system with those of inverted cannulated cancellous screws (ICCS) for the treatment of femoral neck fractures in adults.

This retrospective study evaluated patients with femoral neck fractures who underwent femoral neck system or inverted cannulated cancellous screws internal fixation. The operative time, intraoperative blood loss, number of fluoroscopies, length of surgical incision, length of hospital stay, time to fracture healing, and other indicators were compared between the two groups.

The incidence of complications such as nonunion, avascular necrosis of the femoral head, loosening of the internal fixation, and shortening of the femoral neck during follow-up was also assessed in both groups.

The authors included a total of 92 patients, 47 and 45 patients were categorized into both defined groups, respectively. Follow-up ranged from 14 to 24 months. The study showed that there were no significant between-group differences in sex, age, side of the injured limb, and type of fracture and in operative time, intraoperative blood loss, incision length, and length of hospital stay.

Furthermore, the incidence of complications such as fracture nonunion, avascular necrosis of the femoral head, and screw loosening was also comparable between the two groups.

However, the number of fluoroscopies was significantly lower in the femoral neck system group than in the inverted cannulated cancellous screws group (P < 0.05). The fracture healing time was also significantly lower in the femoral neck system group than in the inverted cannulated cancellous screws group (P < 0.05). Furthermore, the femoral neck shortening and Harris hip score at the last follow-up were significantly better in the femoral neck system group than in the inverted cannulated cancellous screws group (P < 0.05).

As a result, it was concluded that femoral neck fractures can be an alternative to inverted cannulated cancellous screws for the treatment of femoral neck fractures.

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Tang, Y., Zhang, Z., Wang, L. et al. Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study. J Orthop Surg Res 16, 504 (2021). https://doi.org/10.1186/s13018-021-02659-0