Comparison of Early Clinical Results of Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures

Abstract

Objective: To compare the early clinical effects of femoral neck system and three cannulated screws in the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis was conducted on 81 patients who received FNS or cannulated screws internal fixation for Pauwels Type-3 femoral neck fracture in our hospital from January 2019 to December 2019. A pair-matched clinical research was performed. People who received FNS were test group and people received cannulated screws were control group. Matching requirements were as follows： the same gender, the similar age and the similar BMI. A total of 30 pairs were successfully matched, with an average age of 53.84 years old. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative VAS score, time walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the two groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all the patients were followed up for 10-22 months. Patients in the FNS group had lower postoperative VAS scores, earlier time to walk without crutches, higher Harris scores at the last follow-up and lower complication rate (P<0.05). However, intraoperative blood loss and hospitalization costs in the FNS group were more（P<0.05）. There was no statistically significant difference in operation time, hospital stay and femoral head necrosis rate between two group (P>0.05).Conclusion: For patients who were unstable femoral neck fracture, FNS has better clinical efficacy than cannulated screws, though FNS is more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fracture.Fund program: Key medical research project of Jiangsu Health Committee（K2019010）

The ‘Unsolved’ Fracture Neck of Femur– A Comprehensive Review

“…This guided collapse is designed to reduce lateral protrusion. FNS showed less inferior shearing displacement of the femoral head and a greater load to failure when compared to fixation with three cannulated screws [33,34] Proximal Femur Locking Compression Plate (PFLCP):…”