Femoral Neck System versus Three Cannulated Screws for Fixation of Femoral Neck Fractures in Younger Patients: A Retrospective Cohort Study

Objective: To compare the clinical results of a new femoral neck system (FNS) and cannulated compression screws (CCS) for the treatment of femoral neck fractures in younger patients.Methods: Retrospective study was performed in younger patients with femoral neck fractures that were treated with FNS or CCS from August 2017 to August 2022. The hip functional outcomes were assessed with the Harris hip score (HHS). Secondary outcomes included the surgical time, surgical blood loss, satisfaction visual analog scale (VAS), fluoroscopy frequency, fracture healing time and complications.Results: A total of 49 patients (22 FNS and 27 CCS) with a minimum follow-up of 12 months were included. There was also no significant difference in HHSs (p = 0.27) and satisfaction VAS (p = 0.10) between them. Patients with FNS had more blood loss (50.45 +/- 5.28 mL vs. 20.67 +/- 4.71 ml, p < 0.01), lower fluoroscopy frequency (16.64 +/- 3.32 vs. 23.59 +/- 3.39, p < 0.01) and lower fracture healing time (3.76 +/- 0.42 vs. 4.46 +/- 0.59 months, p < 0.01). The femoral neck shortening and incidence of nail withdrawal in the FNS group was significantly lower than CCS group (2.91 +/- 1.95 vs. 4.44 +/- 1.52 mm, p < 0.01; 4.5% vs. 22.2%, p = 0.03).Conclusions: The FNS and CCS get similar hip functions. The FNS can reduce fluoroscopy exposure and the complications such as femoral neck shortening and nail withdrawal. Thus, FNS can be an alternative to CCS for the fixation of femoral neck fractures in younger patients.