Comparison of clinical efficacy between two versus three cannulated compression screws for the treatment of femoral neck fractures without displacement

doi:10.3877/cma.j.issn.2096-0263.2024.05.004

Abstract

Abstract:

Objective

To compare the clinical efficacy of treating non-displaced femoral neck fractures with two versus three cannulated compression screws.

Methods

A retrospective analysis was conducted on 85 patients with non-displaced femoral neck fractures treated with cannulated screws in our hospital from January 2017 to December 2020. The patients were divided into two groups based on the number of fixation screws: the two-screw group and the three-screw group. The two groups were compared in terms of operation time, intraoperative blood loss, fracture healing time, hip joint scores at 6 months postoperatively, and complications such as osteonecrosis and nonunion.

Results

Sixty-nine patients were followed up; 32 in the two-screw group, with a follow-up period of 25.8±4.1 months. This group included 19 males and 13 females, with an average age of (46.3±10.1) years. The three-screw group comprised 37 patients, with a follow-up period of (27.9±5.2) months, including 21 males and 16 females, with an average age of (48.1±7.7) years. The two-screw group showed better results in operation time (44.7±7.1) minutes and intraoperative blood loss (83.5± 8.6 ml) compared to the three-screw group (48.3±3.9) minutes and (88.6±7.9) ml, respectively. The incidence of postoperative osteonecrosis in the two-screw group (21.88%) was significantly lower than in the three-screw group (35.14%) (P<0.001). No significant statistical difference was observed in fracture healing time and hip joint scores.

Conclusions

For Garden I and II type non-displaced femoral neck fractures, two cannulated compression screws can provide sufficient fixation strength, allow early functional rehabilitation, and reduce the destruction of intraosseous blood supply to the femoral head, significantly lowering the rate of postoperative osteonecrosis.

Key words: Femoral neck fractures, Cannulated screws, Fractures without displacement

Yu Zhang, Liangliang Cheng, Feng Wang, Dewei Zhao. Comparison of clinical efficacy between two versus three cannulated compression screws for the treatment of femoral neck fractures without displacement[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(05): 281-286.

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Figures/Tables 6

References 23

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组别	例数	年龄（岁，±s）	性别[例（%）]		患髋[例（%）]		受伤机制[例（%）]		Garden分型[例（%）]
组别	例数	年龄（岁，±s）	男性	女性	左侧	右侧	高能量损伤	低能量损伤	Ⅰ型	Ⅱ型
2枚钉	32	48.71±12.6	19（59.4）	13（40.6）	16（50.0）	16（50.0）	3（9.43）	29（90.6）	10（31.3）	22（68.7）
3枚钉	37	50.32±9.4	21（56.8）	16（43.2）	20（54.1）	17（45.9）	4（10.8）	33（89.2）	22（59.4）	15（40.5）
统计值		t=0.689	t=5.000		t=1.673		t=1.833		t=0.265
P值		0.573	0.126		0.348		0.523		0.847

组别	例数	年龄（岁，±s）	性别[例（%）]		患髋[例（%）]		受伤机制[例（%）]		Garden分型[例（%）]
组别	例数	年龄（岁，±s）	男性	女性	左侧	右侧	高能量损伤	低能量损伤	Ⅰ型	Ⅱ型
2枚钉	32	48.71±12.6	19（59.4）	13（40.6）	16（50.0）	16（50.0）	3（9.43）	29（90.6）	10（31.3）	22（68.7）
3枚钉	37	50.32±9.4	21（56.8）	16（43.2）	20（54.1）	17（45.9）	4（10.8）	33（89.2）	22（59.4）	15（40.5）
统计值		t=0.689	t=5.000		t=1.673		t=1.833		t=0.265
P值		0.573	0.126		0.348		0.523		0.847

组别	例数	手术时间（min）	术中出血量（ml）	骨折愈合时间（月）
2枚钉	32	44.7±7.1	83.5±8.6	3.7±0.9
3枚钉	37	48.3±3.9	88.6±7.9	3.8±0.7
t值		7.371	9.466	0.195
P值		<0.0001	<0.0001	0.845

组别	例数	手术时间（min）	术中出血量（ml）	骨折愈合时间（月）
2枚钉	32	44.7±7.1	83.5±8.6	3.7±0.9
3枚钉	37	48.3±3.9	88.6±7.9	3.8±0.7
t值		7.371	9.466	0.195
P值		<0.0001	<0.0001	0.845

组别	例数	髋关节评分（分）	骨折不愈合率（%）	骨坏死率（%）
2枚钉	32	84.8±4.7	3.13	21.88
3枚钉	37	83.9±3.2	5.41	35.14
统计值		t=1.231	χ²=0.689	χ²=24.37
P值		0.297	0.528	<0.0001

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