Front Surg. 2026 May 11;13:1781748. doi: 10.3389/fsurg.2026.1781748. eCollection 2026.
ABSTRACT
OBJECTIVE: To compare the outcomes of femoral neck shortening between the Femoral Neck System (FNS) and FNS combined with Cannulated Compression Screws (CCS) in the treatment of displaced femoral neck fractures in young and middle-aged patients.
METHODS: A retrospective analysis was conducted on 163 young and middle-aged patients with displaced femoral neck fractures who underwent either FNS or FNS combined with CCS internal fixation surgery in the Department of Trauma Orthopedics at the Sixth Affiliated Hospital of Xinjiang Medical University between September 2019 and January 2023. According to the internal fixation method, patients were divided into the FNS group (n = 94) and the combined group (n = 69). There were 76 males and 87 females, aged 39 to 61 years, with a mean age of 52.5 years. The causes of injury included 94 cases of road traffic injuries, 31 cases of high falls, and 38 cases of falls. According to the Garden classification, there were 44 cases of type III and 119 cases of type IV. Differences in perioperative indicators, femoral neck shortening, hip joint function, and complications were compared between the two groups.
RESULTS: There were no statistically significant differences between the two groups in terms of age, gender, injury mechanism, injury location, Garden classification, time from fracture to surgery, or the presence of cardiovascular diseases, diabetes, smoking history, or alcohol history (P > 0.05). The operative time and intraoperative blood loss in the combined group were significantly greater than those in the FNS group [142 (112, 152) min vs. 81 (76, 92) min; 86 (77, 92) mL vs. 56 (51, 66) mL], with statistical significance (P < 0.05). The degree of femoral neck shortening in the combined group was significantly lower than that in the FNS group at 3 months (1.58 ± 0.32 mm vs. 3.04 ± 0.68 mm), 9 months (2.65 ± 0.52 mm vs. 3.98 ± 0.30 mm), and 15 months (2.88 ± 0.79 mm vs. 4.62 ± 1.09 mm) postoperatively, with statistical significance (P < 0.05). There were no statistically significant differences between the two groups in reduction quality, postoperative hospital stay, hip Harris score, or complication rates (P > 0.05).
CONCLUSION: Although FNS combined with CCS can reduce the degree of femoral neck shortening in patients with femoral neck fractures, it requires higher surgical expertise, longer operative time, and greater intraoperative blood loss. Surgeons should select the appropriate surgical approach based on the patient's specific circumstances.
PMID:42199891 | PMC:PMC13199279 | DOI:10.3389/fsurg.2026.1781748