A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures.

Femoral neck fractures (FNF) are a significant concern, particularly in elderly patients with osteoporosis and younger individuals experiencing high-energy traumas. Traditional treatments, like cannulated compression screws (CCSs), often result in complications such as avascular necrosis (AVN). This study evaluated the effectiveness of bidirectional compression porous tantalum screws (BCPTSs) against conventional CCSs in FNF treatment. A retrospective study was conducted on 109 patients with FNF treated at Zhongshan Hospital, Dalian University, from January 2016 to December 2020. Patients were divided into three groups based on the fixation method: two CCSs, three CCSs, and BCPTSs. Postoperative outcomes were assessed using anteroposterior radiographs, with follow-up evaluations at six weeks, three months, 12 months, and 24 months. Diabetic patients were also included as subjects of observation to analyze the association between postoperative osteonecrosis and diabetes. In the two CCSs group, seven patients (7/20, 35%) experienced AVN, compared to 17 patients (17/39, 43.58%) in the three CCSs group. In contrast, only one patient (1/50, 2%) in the BCPTSs group developed nonunion, with no cases of AVN. In a comparison among diabetic patients, there was one case of postoperative AVN in the two CCSs group, five cases in three CCSs group, and one case of fracture nonunion in the BCPTSs group. BCPTSs offer a superior alternative to conventional CCSs in treating FNF, particularly in reducing AVN and nonunion rates. The study highlights the importance of vascular preservation and contributes a new option for treating FNF.