Efficacy and risk factor analysis of femoral neck system for femoral neck fractures：a retrospective study

Abstract Background To analyze the efficacy of the femoral neck system (FNS) in treating patients with femoral neck fracture (FNF) after surgery and the risk factors leading to complications such as femoral head necrosis (FHN), fracture nonunion (FN), and hardware removal (HR). Methods The study retrospectively included 109 patients and 109 FNF that underwent closed reduction by FNS between January 2019 and December 2021 in our single tertiary medical institution. The complications and reoperation rate of FNS and the underlying risk factors were evaluated. Results There are 109 patients included in the study, The overall reoperation rate is 6.4% (5 patients with FHN and 2 patients with HR) and the overall complication rate is 10.09% (6 patients with FHN, 2 patients with HR, and 3 patients with FN). For the 109 patients in the study, risk factors for complication included patient’s gender, Pauwels angle, length of femoral neck shortening. Pauwels classification, length of operation, volume of blood loss, and length of incision are also related to complications. Conclusion FNS is a safe option for treating FNF, the reoperation rate and the complication rate of FNS are lower than other implants. Female patients, Pauwels angle, and length of femoral neck shortening are the main risk factors of complications. Excessive pursuit of anatomical reduction is also associated with the development of complications.