Efficacy of femoral neck internal fixation system versus arthroplasty in treatment of Pauwels type Ⅲ femoral neck fracture

Objective To investigate the efficacy of femoral neck system (FNS) for internal fixation versus arthroplasty in the treatment of Pauwels type Ⅲ femoral neck fracture. Methods A retrospective analysis was performed for the data of 96 patients with Pauwels type Ⅲ femoral neck fracture who received surgical treatment in our hospital from January 2019 to January 2021, and according to the surgical procedure, they were divided into FNS group with 39 patients and arthroplasty group with 57 patients. The two groups were compared in terms of general information, admission and surgery data, and Harris score of the hip joint at 12 months after surgery. Results Compared with the FNS group, the arthroplasty group had a significantly longer time of operation and a significantly greater intraoperative blood loss (t=9.27,t'=92.81,P<0.05), as well as significantly shorter length of hospital stay and postoperative weight-bearing time (t=14.61,23.21,P<0.05). There was no significant difference in Harris score at 12 months of follow-up between the two groups (P>0.05). At 12 months of follow-up, 5 patients in the FNS group and 6 in the arthroplasty group experienced postoperative complications, and there was no significant difference between the two groups (P>0.05). Conclusion For patients with Pauwels type Ⅲ femoral neck fracture, arthroplasty can shorten the length of hospital stay, achieve early weight-bearing and functional exercise, and reduce the time of lying in bed. An appropriate artificial prosthesis should be selected for arthroplasty according to the specific condition of the patient, so as to bring more benefits to the patient.