We retrospectively analyzed young patients with FNFs in our hospital between January 2017 and January 2020 (all included patients were less than 60 years old). Fixation of the femoral head is achieved with a screw locked into a bolt to allow these components to slide together along the plate barrel for dynamic fixation. The implant with its small side plate provides fixation to the femoral shaft while allowing a reduced implant footprint. 1 showed the schematic diagram of femoral neck system). Recently, a new minimally invasive implant has been developed for the dynamic fixation of FNFs called the femoral neck system (FNS) (Fig. For Pauwel type III, basicervical, and highly comminuted unstable fracture patterns, a DHS offers greater mechanical stability to resist the increased shearing forces generated and should be used in place of cancellous screws. Pauwel type I and most type II fractures may be effectively managed with three parallel cancellous lag screws inserted in an inverted triangular configuration, entering at or above the level of the lesser trochanter. Among these internal fixations, cancellous lag screws are the most widely used screws in clinical practice. Orthopedic surgeons have to choose the most effective implant to treat FNFs, especially in young patients.įor young adults, the treatment of choice is either CRIF or ORIF with cannulated compression screws (CCS) or a dynamic hip screw (DHS). This is accompanied by an enormous socioeconomic burden and medical challenges. A meta-analysis reviewed 1558 FNFs from 41 studies and concluded that the incidence of AVN was 14.3%, and the incidence of nonunion was 9.3% in younger patients. įor young patients with FNFs, CRIF and open reduction and internal fixation (ORIF) are currently the most widely recognized treatment plans, but there is still a high incidence of postoperative complications, such as avascular necrosis (AVN), fracture nonunion, and femoral neck shortening. Anatomical reduction and effective fixation are essential for obtaining good prognosis and function. So young patients with FNFs prefer open or closed reduction and internal fixation (CRIF). For young patients, the goal of surgical treatment is to retain the femoral head as much as possible, avoid necrosis of the femoral head, and achieve bone healing. For young people, fractures of the femoral neck are usually caused by high-energy trauma, such as falls from high places or high-speed traffic accidents. FNFs are most common in the elderly population, but the treatment of FNFs in relatively young patients deserves our attention. FNS has excellent biomechanical properties and shows significantly higher overall construct stability.įemoral neck fractures (FNFs) are a common injury in orthopedic practice and result in significant morbidity and mortality. Patients younger than 60 with femoral neck fractures can obtain satisfactory clinical results with CCS or FNS treatment. Regarding postoperative complications, there was no statistical difference in the incidence of femoral head necrosis and fracture nonunion between the two groups. The degree of femoral neck shortening in the FNS group was significantly lower than that in the CCS group (10.0% vs 37.5%, p = 0.036). Patients who underwent FNS treatment had longer surgery time (79.75 ± 26.35 min vs. There was no statistical difference in HHSs between the two groups before surgery. There were no significant differences in age, sex, or body mass index between the two groups. We recorded related surgical complications, including femoral head necrosis, nonunion, and femoral neck shortening. General data (such as sex, age, body mass index, type of fracture) of all patienFemoral neck shorteningts were collected, and joint function was evaluated using the Harris Hip Score (HHS) before and 1 year after surgery. Cannulated compression screws (CCS) and FNS groups were divided according to different internal fixation methods. We retrospectively studied patients who underwent internal fixation surgery in our hospital for femoral neck fractures between January 2017 and January 2020. The main purpose of this study was to evaluate two different internal fixation methods for the treatment of femoral neck fractures in patients aged under 60 years. The clinical outcome of a new fixation device (femoral neck system, FNS) for femoral neck fractures remains unclear.
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