Femoral neck system or combined cannulated screws for femoral neck fracture
Li Yongwang1, Long Yubin1, He Rongli2, An Ming1, Zhang Qian1, Qi Hui1, Han Zhe1, Ma Wenhai1
1Third Department of Orthopedics, Baoding First Central Hospital, Baoding 071000, Hebei Province, China; 2Department of Gastroenterology, Baoding Second Hospital, Baoding 071000, Hebei Province, China
Abstract: BACKGROUND: Femoral neck fractures can be treated with cannulated screws, dynamic hip screws, locking plates, and intramedullary nails. However, there are still high risks of internal fixation failure, femoral neck shortening, varus deformity, femoral head necrosis and nonunion. The femoral neck system is minimally invasive and provides stable rotation resistance with minimal screw cutting and screw withdrawal.
OBJECTIVE: To compare early clinical effects of femoral neck system and femoral neck system combined with cannulated screw on femoral neck fracture.
METHODS: The data of 42 patients with femoral neck fracture treated in Department of Orthopedics, Baoding First Central Hospital from March 2020 to October 2021 were retrospectively analyzed. Of them, 33 patients were followed up and divided into femoral neck system group (group A; n=26) and femoral neck system combined with cannulated screw group (group B; n=7). Operation time, intraoperative fluoroscopy times, intraoperative blood loss, length of hospital stay, fracture healing time, curative effect (Harris score) and complications at the last follow-up were recorded.
RESULTS AND CONCLUSION: (1) Thirty-three patients were followed up for 3-19 months. (2) Operation time, intraoperative fluoroscopy times, and intraoperative blood loss were significantly less in group A than those in group B (P < 0.05). Length of hospital stay and Harris score postoperatively and at final follow-up were not significantly different (P > 0.05). Hip function was evaluated as follows: excellent in 15 cases, good in 9 cases, and average in 2 cases in group A; excellent in 6 cases and good in 1 case in group B. (3) Postoperative X-ray films showed that all fractures healed, and the healing time was 3-6 months, with an average of 4.5 months. (4) There was no significant difference in the degree of femoral neck shortening between the two groups after operation and at the final follow-up (P > 0.05). (5) None of the patients had complications such as infection and loosening of internal fixation during follow-up. (6) The treatment of femoral neck fractures with femoral neck system or combined with cannulated screw fixation is simple and minimally invasive with satisfactory short-term results.
Key words: femoral neck fractures, fracture fixation, femoral neck system, cannulated screw, internal fixation, minimally invasive