Comparative study on the clinical efficacy of femoral neck system and cannulated cancellous screw in the treatment of femoral neck fractures in young patients.

OBJECTIVE: To investigate the clinical efficacy of femoral neck system and hollow compression screw in the treatment of femoral neck fractures in young patients. METHODS AND MATERIALS: A retrospective study was conducted on young patients with femoral neck fractures who underwent treatment with either the Femoral Neck System (FNS) or Cannulated Cancellous Screws (CCS) between June 2018 and June 2023. The primary outcome was evaluated using the Harris Hip Score (HHS) to assess hip functional outcomes. Secondary outcomes included operative time, intraoperative blood loss, satisfactory Visual Analogue Scale (VAS) scores, fluoroscopy frequency, fracture healing time, complications, and femoral neck shortening at 3 and 6 months postoperatively. RESULTS: A total of 70 patients were included (35 in the FNS group and 35 in the CCS group), with follow-up ranging from 24 to 120 weeks. The mean follow-up duration was 74.22 ± 33.27 weeks in the FNS group and 75.17 ± 27.52 weeks in the CCS group. No statistically significant difference was observed in Harris Hip Scores (HHS) between the two groups. However, the fracture healing time in the FNS group (14.44 ± 2.42 weeks) was significantly shorter than that in the CCS group (16.42 ± 2.84 weeks) (P < 0.05). Similarly, the time to full weight-bearing was earlier in the FNS group (11.83 ± 3.98 weeks) compared to the CCS group (19.32 ± 4.12 weeks) (P < 0.05). The FNS group also demonstrated lower fluoroscopy frequency (P < 0.05) and superior femoral neck shortening outcomes (P < 0.05) postoperatively. Regarding complications, the FNS group exhibited a lower rate of internal fixation failure. No statistically significant differences were observed between the two groups in other perioperative parameters, postoperative efficacy metrics, or additional complication rates (P > 0.05). CONCLUSION: For young patients with femoral neck fractures, while both FNS and CCS achieved similar final functional outcomes, the FNS system facilitates a more favorable recovery course by promoting faster fracture healing, enabling earlier weight-bearing, and most importantly, significantly reducing the risk of major postoperative complications. These advantages are attributable to its enhanced biomechanical stability.