Comparison of Femoral Neck System and Cannulated Compression Screw in the Treatment of Pauwels Type Ⅲ Femoral Neck Fractures in Young and Middle-aged Patients
Objective To compare the clinical efficacy of the femoral neck system(FNS)and cannulated compression screw(CCS)in the treatment of Pauwels type Ⅲ femoral neck fractures in young and middle-aged patients.Methods We retrospectively studied 103 clinical cases of young and middle-aged patients with Pauwels type Ⅲ femoral neck fractures who were treated with internal fixation surgery between January 2019 and August 2022.According to different surgical methods,they were divided into FNS group(54 cases)and CCS group(49 cases).The intraoperative bleeding volume,operation time,quality of fracture reduction(Garden alignment index),bone healing time,postoperative weight-bearing time,postoperative complications,shortening length of femoral neck,change of femoral neck-shaft angle(difference between immediately after operation and at the last follow-up),and Harris hip score were compared between the two groups.Results Compared to the CCS group,the FNS group had significantly shorter operation time[(46.7±12.3)min vs.(69.7±14.1)min,t=-8.840,P=0.000],reduced postoperative weight-bearing time[(11.5±2.7)weeks vs.(15.7±3.2)weeks,t=-7.124,P=0.000],shorter fracture healing time[(3.7±0.8)months vs.(4.3±0.9)months,t=-3.625,P=0.001],and significantly lower incidence of complications[1.8％(1/54)vs.14.3％(7/49),x2=3.944,P=0.047].The FNS group also demonstrated significantly higher Harris hip scores at 3 months[(84.5±3.9)points vs.(82.7±4.4)points,t=2.212,P=0.029],6 months[(91.4±4.4)points vs.(89.7±4.0)points,t=2.119,P=0.037],and 1 year[(96.0±2.8)points vs.(94.8±3.1)points,t=2.029,P=0.045]postoperatively compared to the CCS group.At the last follow-up,the FNS group showed significantly shorter femoral neck shortening[(4.6±2.8)mm vs.(5.9±3.3)mm,t=2.165,P=0.033]compared to the CCS group.Conclusions Compared to CCS,FNS shows better efficacy in the internal fixation of Pauwels type Ⅲ femoral neck fractures with a shorter bone healing time.With the application of FNS,the rehabilitation of the hip joint is promoted,and the hip joint function is effectively improved,as well as the incidence of postoperative complications is reduced.
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