![]() This study aimed to compare the clinical efficacy and postoperative outcome between FNS and CCS in the treatment of femoral neck fractures in population of below 65 years of age. The clinical efficacy and postoperative outcome of internal fixation using FNS compared to that of the traditional cannulated cancellous screw remained not very well documented. Some authors have recently reported important findings regarding the mechanic and the biomechanical stability of the internal fixation using FNS in unstable femoral neck fractures according to the authors, the Placement of the bolt tip of FNS at proximity and inferiorly to the subchondral bone in pauwels III femoral neck fractures respectively provided higher stability and increased inter-fragmentary sliding distance additional 5 mm gap between the diaphysis and the plate probably adjust the depth of the bolt. The femoral neck system (FNS), designed by the Association for the Study of Internal Fixation and DePuy Synthes combines the advantages of both cannulated screw and DHS. However it has limitation in overcoming the vertical shear instability encountered in Pauwels type III femoral neck fracture in which case the DHS is the best alternative. The CCS presents some advantages as it provides the torsional stability and preservation of blood vessels in the femoral head and neck. The cannulated cancellous screw (CCS) and the Dynamic Hip Screw (DHS) are widely used. The surgical management and the implant selection is still a challenging task among orthopedic specialist. There have been an estimated 20–30% incidence rate of complications in patients after femoral neck fracture among which avascular necrosis, implant failure, nonunion and malunion are the most incriminated. While in elderly population the femoral neck fracture is due to low energy force, in younger population it is mostly due to high energy trauma such as fall from the height or Road traffic accidents. Considering factors such as population growth and ageing, the incidence of femoral neck fractures (which was 1.6 million people per year in 1990) is projected to increase to 2.6 million in 2025 and 6.3–6.5 million by the year 2050 with serious socioeconomic impact, and significant challenges to orthopedic surgeons. The fractures of femoral neck account for 50% among hip fractures with around 3%-10% occurring in younger population of below 65 years therefore, they are considered as a major public health concern. ConclusionįNS presented satisfactory outcomes had significantly lower complications rate, therefore, can be one of the alternatives for internal implantation devices in treatment of femoral neck fracture in non-geriatric population. The significant differences were also found in terms of numbers of fluoroscopies 8.34 ± 1.38 Vs 17.72 ± 2.19, the HHS 87.80 ± 1.92 Vs 84.28 ± 2.24, postoperative complications 8 (14.28%) Vs 26 (44.82) respectively in FNS and CCS group. However, the fracture healing time between FNS group and CCS group was statistically significant ( p < 0.05), respectively 2.86 ± 0.77 and 5.10 ± 0.81 months. ResultsĪll 114 patients presented satisfactory reduction and were followed-up for a period of 12 to 36 months (mean 27 ± 2.07 months) there were no significant differences between both groups in terms of age, gender, fracture classification, side of injury, mechanism of injury, the operative time, intraoperative blood loss and the hospital length of stay. ![]() The variables of interest including demographic and clinical variables (age, gender, fracture mechanism, injury side and classification), perioperative parameters(operation time, intraoperative bleeding, incision length and hospitalization time), postoperative outcomes and complications (fracture healing time, nonunion rate, femoral neck avascular necrosis, aseptic screw loosening and the Harris Hip Score), were analyzed and compared between the two groups. Methodsĭata of 114 patients between 18–65 years, admitted in our department for femoral neck fracture from January 2019 to March 2021 were retrospectively studied and ranged into two groups based on the surgical methods: FNS group (56 patients) and CCS group (58 patients). The aim of this study was to compare the clinical efficacy and outcome of the femoral neck system (FNS) and the cannulated cancellous screw (CCS) in the treatment of femoral neck fractures in adult below 65 years of age. The newly introduced FNS as management approach appears to be a potential alternative to the traditional CCS. The fractures of femoral neck account for 50% among hip fractures with around 3%-10% occurring in younger population of below 65 years.
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