Gao Yang, Ma Tianle, Chang Xiaohu, Jia Peng, Li Xiaoteng, Tang Xin
Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning Province, China.
Department of Orthopedics, Zhongshan Hospital Affiliated to Fudan University, Shanghai, 200032, China.
J Orthop Surg Res. 2025 Jan 18;20(1):65. doi: 10.1186/s13018-025-05461-4.
This study aimed to evaluate the clinical effectiveness of the femoral neck system (FNS) compared to four cannulated compression screws (CCSs) for managing Pauwels type III femoral neck fractures in young patients.
A retrospective analysis was conducted on young patients with Pauwels type III femoral neck fractures treated at our hospital from January 2021 to December 2022. Patients were categorized into two groups based on their respective internal fixation methods: the FNS group (32 cases) and the CCSs group (41 cases). Various demographic and clinical variables, including age, gender, fracture side, mechanism of injury, Garden classification, and time interval between injury and surgery, were collected. Comparisons were made between the two groups regarding operative duration, intraoperative blood loss, length of hospital stay, hospitalization expenses, time to fracture healing, and Harris hip score at one year post-surgery. Additionally, postoperative complications such as wound infections, nonunion, femoral neck shortening, avascular necrosis of the femoral head, and hardware failure were analyzed. Follow-up duration ranged from 12 to 24 months for all patients.
There were no significant differences between the FNS and CCSs groups in terms of demographic characteristics, fracture characteristics, time to fracture healing, duration of hospital stay, and Harris hip score at one year post-surgery (p > 0.05). However, the CCSs group exhibited significantly shorter operative time, reduced intraoperative blood loss, and lower hospitalization costs compared to the FNS group (p < 0.05). Patients treated with FNS had longer operative durations (82.33 ± 28.85 min vs. 66.58 ± 14.38 min, p = 0.006), higher blood loss (106.67 ± 65.83 mLvs.70.00 ± 27.39 mL, p < 0.001), and increased hospitalization expenses (58,345.98 ± 3706.57 RMB vs. 35,427.63 ± 3019.30 RMB, p < 0.0001). The incidence of postoperative complications was 21.8% in the FNS group and 26.8% in the CCSs group (p > 0.05), with no significant differences observed in the rates of wound infections, femoral neck shortening, femoral head necrosis, nonunion, and hardware failure between the two groups (p > 0.05).
In the management of Pauwels type III femoral neck fractures in young patients, FNS demonstrates clinical efficacy comparable to CCSs. However, considering factors such as operative time, intraoperative blood loss, and hospitalization costs, CCSs may be preferred.
本研究旨在评估股骨颈系统（FNS）与四颗空心加压螺钉（CCS）相比，在治疗年轻患者 Pauwels III 型股骨颈骨折中的临床疗效。
对 2021 年 1 月至 2022 年 12 月在我院接受治疗的年轻 Pauwels III 型股骨颈骨折患者进行回顾性分析。根据各自的内固定方法将患者分为两组：FNS 组（32 例）和 CCS 组（41 例）。收集了各种人口统计学和临床变量，包括年龄、性别、骨折侧、损伤机制、Garden 分级以及受伤至手术的时间间隔。比较了两组在手术时间、术中出血量、住院时间、住院费用、骨折愈合时间以及术后一年的 Harris 髋关节评分。此外，分析了术后并发症，如伤口感染、骨不连、股骨颈缩短、股骨头缺血性坏死和内固定失败。所有患者的随访时间为 12 至 24 个月。
FNS 组和 CCS 组在人口统计学特征、骨折特征、骨折愈合时间、住院时间以及术后一年的 Harris 髋关节评分方面无显著差异（p＞0.05）。然而，与 FNS 组相比，CCS 组的手术时间明显更短，术中出血量减少，住院费用更低（p＜0.05）。接受 FNS 治疗的患者手术时间更长（82.33±28.85 分钟 vs. 66.58±14.38 分钟，p = 0.006），出血量更高（106.67±65.83 mL vs. 70.00±27.39 mL，p＜0.001），住院费用增加（58,345.98±3706.57 元 vs. 35,427.63±3019.30 元，p＜0.0001）。FNS 组术后并发症发生率为 21.8%，CCS 组为 26.8%（p＞0.05），两组在伤口感染、股骨颈缩短、股骨头坏死、骨不连和内固定失败发生率方面无显著差异（p＞0.05）。
在年轻患者 Pauwels III 型股骨颈骨折的治疗中，FNS 显示出与 CCS 相当的临床疗效。然而，考虑到手术时间、术中出血量和住院费用等因素，CCS 可能更受青睐。
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