FNS as a more satisfactory surgical option for young and middle-aged patients with femoral neck fractures

There is currently no consensus on the optimal treatment for femoral neck fractures in middle-aged and young adults. This research seeks to evaluate and compare the clinical efficacy of three different approaches: three cannulated screws (CS), a dynamic hip system combined with cannulated screws (DHS), and a new femoral neck system (FNS) in the management of these fractures. Seventy-eight middle-aged and young patients admitted for femoral neck fractures were divided into three groups based on the surgical procedure: CS, DHS, and FNS groups. The surgical time, incision length, intraoperative blood loss, number of fluoroscopies, Harris Hip Score and postoperative complications among the groups were compared. All patients were followed for 16 to 24 months, with an average follow-up duration of 18.42 ± 2.25 months. The operation times, intraoperative blood losses, the median and interquartile range for incision length, all showing significant differences. The median number of intraoperative X-ray fluoroscopies was 28 (8) for the CS group, 16 (6) for the DHS group, and 11 (7) for the FNS group, with significant differences between the CS group and both the DHS and FNS groups. The complication rates showed significant differences between the CS group and the other two groups. At the 3- and 6-month follow-ups, there were no statistically significant differences in Harris Hip scores among the three groups. However, at the final follow-up, the scores were 80.39 ± 6.81 (CS), 87.13 ± 3.43 (DHS), and 87.95 ± 3.58 (FNS), with the CS group showing significantly lower scores compared to the DHS and FNS groups, indicating a better overall outcome for the latter two. Treating young and middle-aged patients with femoral neck fractures using CCS, DHS, or FNS resulted in satisfactory clinical outcomes. In comparison to CCS, DHS and FNS reduced intraoperative fluoroscopy use, shortened surgery times, and minimized complications such as femoral neck shortening, nonunion, and femoral head necrosis. Furthermore, the FNS group had a smaller incision length and a shorter operation time than the DHS group.