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Comparison of femoral neck system to multiple cancellous screws and dynamic hip screws in the treatment of femoral neck fractures

  • Xiangyu Xu
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
    Search for articles by this author
  • Jixing Fan
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
    Search for articles by this author
  • Fang Zhou
    Correspondence
    Corresponding author at: Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, China.
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
    Search for articles by this author
  • Yang Lv
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
    Search for articles by this author
  • Yun Tian
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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  • Hongquan Ji
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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  • Zhishan Zhang
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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  • Yan Guo
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
    Search for articles by this author
  • Zhongwei Yang
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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  • Guojin Hou
    Affiliations
    Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China

    Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
    Search for articles by this author

      Highlights

      • Femoral neck system, multiple cancellous screws, and dynamic hip screws are effective for femoral neck fractures.
      • Femoral neck system is a simpler operation, with earlier weight-bearing time, than multiple cancellous screws.
      • The main advantage of femoral neck system over dynamic hip screws is a minimally invasive operation.

      Abstract

      Objective

      To compare the short-term outcomes of the femoral neck system (FNS) with multiple cancellous screws (MCS) and dynamic hip screws (DHS) in the treatment of femoral neck fractures.

      Methods

      A retrospective analysis was performed on 157 patients with fresh femoral neck fractures treated with FNS (from September 2019 to October 2020), MCS, and DHS (from January 2018 to October 2020). According to internal fixation methods, all patients were divided into the FNS group (54 cases), MCS group (51 cases), and DHS group (52 cases). Demographic data were also collected, recorded, and compared, including the follow-up time, days of hospitalization, operation time, blood loss, intraoperative fluoroscopy times (IFT), weight-bearing time (WBT), length of femoral neck shortening (LFNS), Harris hip score, and complications (such as internal fixation failure, bone nonunion, and avascular necrosis of the femoral head) between the three groups.

      Results

      Overall, 157 patients with a mean age of 61.8 (range, 18–89) years were analyzed. In the FNS group, IFT (median 10.5) was significantly lower than that in the MCS group (median 21) and DHS group (median 20.5) (P<0.05), and WBT was significantly earlier than that of the MCS group (P<0.05). In the FNS group, the median hospitalization time, operation time, and blood loss were 2 (2, 4) days, 45 (40–59) min, and 30 (20, 50) ml, respectively. They were all significantly less than 3.5 (3, 6) days, 72 (55–88.75) min, and 50 (30, 50) ml in the DHS group, respectively (P < 0.05). There was no statistical difference in LFNS, quality of reduction, internal fixation failure rate, and Harris hip score at the latest follow-up (P>0.05). No surgical complications such as incision infection, deep infection, pulmonary embolism, or femoral head necrosis were found in any of the three groups.

      Conclusion

      FNS, MCS, and DHS are all effective for femoral neck fractures. However, a lower IFT of FNS shortens the operation time. Compared to MCS, FNS has the advantages of being a simple operation, with early WBT; compared to DHS, a minimally invasive operation is the main advantage of FNS.

      Keywords

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