Evaluation of functional outcome following internal fixation of femoral neck fracture with cannulated cancellous screws: a prospective study from Bangladesh

Background: Femoral neck fracture is a significant cause of morbidity in adults admitted to tertiary care centers in Bangladesh, and internal fixation with cannulated cancellous screws is the preferred head-preserving procedure in physiologically fit patients. This study aimed to assess the functional results, radiological healing, and complication rate of cannulated cancellous screw fixation of femoral neck fractures. Methods: This concurrent prospective observational study was carried out at the Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh, from January 2024 to December 2024, on 45 patients with femoral neck fracture who were treated with closed or open reduction and internal fixation with 3 or 4 cannulated cancellous screws. Demographic, fracture, and operative data were collected, and functional outcome was evaluated at 3, 6, and 12 months after surgery using the Harris Hip Score (HHS). The data were analyzed using SPSS version 26. Results: The age group 31-40 years was the largest (24.4%), and there was a significant male predominance (71.1%). The most common mechanism of injury was road traffic accidents (53.3%). The most common fracture type was type III (37.8%), and the majority of fractures (86.7%) were closed reduction with anatomical alignment. Radiological union was obtained in 91.1% of patients, avascular necrosis in 11.1%, and shortening of the femur in 15.6%. The percentage of patients with excellent-to-good HHS increased from 22.2% at 3 months to 68.9% at 12 months. Conclusion: Although early diagnosis, early surgery, and anatomical reduction are key to reducing complications, the union rate and functional recovery are progressive and favorable for femoral neck fractures treated with cannulated cancellous screw fixation.