Comparison of the Efficacy of Two Internal Fixation Methods in the Treatment of Unstable Femoral Neck Fracture in Young and Middle-Aged Patients
Objective To compare the short and medium term efficacy and prognosis of femoral neck dynamic cross napping system and multiple hollow compression screws in the treatment of young and middle-aged unstable femoral neck fractures.Methods A retrospective analysis was conducted on data from 112 patients who sustained femoral neck fractures and met the inclusion criteria between October 2020 and October 2023.The patients were divided into two treatment groups based on the surgical approach:femoral neck system(FNS)and multiple cannulated screws(MCS).The FNS group comprised 55 patients,including 21 males and 34 females,with a mean age of(56.05±7.53)years(ranging from 33 to 65 years).The MCS group included 57 patients,comprising 24 males and 33 females,with a mean age of(55.04±8.32)years(ranging from 29 to 65 years).Initially,baseline characteristics of both groups were compared.Subsequently,perioperative indicators,such as surgical incision length,operative time,intraoperative blood loss,fluoroscopy time,and the need for assisted reduction,were analyzed to identify differences in surgical data between the FNS and MCS groups.Additionally,follow-up outcomes,including hospital stay,time to weight-bearing,Harris hip scores,visual analogue scale(VAS)pain scores,and postoperative complications,were evaluated.Finally,changes in femoral neck shortening at 3 and 6 months post-surgery were assessed to determine the effectiveness of each treatment modality.Statistical comparisons were made to evaluate the differences in outcomes between the FNS and MCS groups.Results Among the 112 patients,111 patients completed follow-up for a period ranging from 24 to 144 weeks.The mean follow-up time was(74.17±36.76)weeks in the FNS group and(77.75±32.49)weeks in the MCS group.Comparative analysis revealed that the fracture healing time in the FNS group(13.20±2.13)weeks was significantly shorter than that in the MCS group(15.39±4.42)weeks(P＜0.05).Similarly,the complete weight-bearing time in the FNS group(11.76±4.22)weeks was earlier than that in the MCS group(19.39±4.42)weeks(P＜0.05).Furthermore,the femoral neck shortening length and hip function scores,as assessed by the Harris hip score,were significantly better in the FNS group compared to the MCS group(P＜0.05).In terms of postoperative complications,the FNS group exhibited a lower rate of internal fixation failure(1.82％),although this difference did not reach statistical significance when compared to the MCS group.Notably,no statistically significant differences were observed between the two groups in terms of other perioperative parameters,postoperative outcomes,or the overall incidence of complications(P＞0.05).Conclusion When compared to the conventional MCS technique,the FNS technique offers several advantages in the treatment of unstable femoral neck fractures in middle-aged and young adults.Specifically,it embodies the technical merits of minimally invasive surgery,providing both better static stability and a dynamic compression effect.These attributes enable patients to commence early weight-bearing and rehabilitation exercises,thereby potentially reducing the incidence of postoperative complications.
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