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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Article info
Publication history
Published online: March 24, 2022
Accepted:
March 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd. All rights reserved.