Short-term effect of femoral neck system(FNS)combined with cannulated screws in the treatment of unstable femoral neck fractures
Objective To compare the surgical effect of different locations of the femoral neck system(FNS)combined with cannulated screws(CS)in the treatment of unstable femoral neck fractures.Methods A retrospective analysis was made on 126 patients with unstable femoral neck fractures treated in the First Department of Traumatic Orthopaedics,the Sixth Affiliated Hospital of Xinjiang Medical University from Sep.2019 to Aug.2022,including 54 males and 72 females aged 33-65(mean 44.6)years.The causes of injury were ground-level falls in 86 cases,road traffic injuries in 21 and falls from height in 19.According to the position of the FNS power rod detec-ted by immediate postoperative X-rays and whether cannulated screws were combinedly used,patients were divided into groups A,B and C.In group A,the FNS power rod was located in the middle 1/3 of the femoral head and no use of CS(with 59 cases,including 30 males and 29 females aged 34-64 years,mean 46.6 years).In group B,the FNS power rod was located in the inferior 1/3 of the femoral head and no use of CS(with 39 cases,including 13 males and 26 females aged 33-63 years,mean 41.7 years).In group C,the FNS power rod was located in the inferior 1/3 of the femoral head combined with the use of CS(with 28 cases,including 11 males and 17 females aged 33-65 years,mean 43.9 years).All patients were followed up for at least 1 year.The general clinical data,operation-related characteristics,hospitalization and short-term operative complications,and Harris hip function score(HHS)at the last follow-up were observed and compared among the three groups.Results Compared with groups A and B,group C revealed much more times of intraoperative fluoroscopy(32.1±7.9 vs.24.6±4.2 and 24.9±6.2),less inci-dence of hip varus(O vs.12/39 and 5/28),and earlier weight bearing start time(d,10.8±1.4 vs.11.6±1.7 and 12.1±1.6)and fracture healing(weeks,15.1±1.1 vs.15.8±1.5 and 16.1±1.4),all revealing statistically signifi-cant differences(all P＜0.05).Other outcome indexes showed no significant difference among the three groups(all P＞0.05).Conclusion The combined use of FNS and CS for unstable femoral neck fractures,though requires more times of X-ray fluoroscopy,shows quicker recovery and less hip varus than FNS alone.
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