Evidence map›Paper›PMID 41117917›Full record

ArticleInternational orthopaedics2025

Clinical outcomes of femoral neck fractures in nongeriatric patients: a comparative analysis of parallel screws, alpha fixation and femoral neck system.

Dajun Jiang, Jiaqing Cao, Jinhui Zhao, Yuquan Bian, Shizan He, Weitao Jia

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. [Early effectiveness of surgical hip dislocation combined with autologous iliac crest bone grafting in treatment of femoral neck fracture nonunion in adolescents].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dajun JiangShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jiaqing CaoShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jinhui ZhaoShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yuquan BianShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shizan HeShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Weitao JiaShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. jiaweitao@shsmu.edu.cn.

Funding

Shanghai Science and Technology Innovation Action Plan 22Y11912500Shanghai Shenkang Development Center Research Physician Innovation and Transformation; Capability Training Program SHDC2023CRD015
6 · The paper itself

Abstract

purposeFemoral neck fractures in nongeriatric patients pose a significant clinical challenge due to the high clinical failure rate. To address this, Alpha fixation and the Femoral Neck System (FNS) were developed but seldom been compared head-to-head. The purpose of this study was to compare the clinical prognosis of these two methods with traditional parallel screws.

methodsThis retrospective cohort study included 341 patients aged 18-65 years, treated between June 2020 and June 2023. Patients were grouped by fixation strategies: (1) parallel screws (n = 206), (2) Alpha fixation (n = 73), and (3) FNS (n = 62). Fixation failure (nonunion, severe femoral neck shortening, varus collapse) was compared as primary clinical outcome using univariate and multivariate analyses. Secondary outcomes included avascular necrosis and reoperation rates. Analyses were stratified by Pauwels classification.

resultsFixation failure rates were highest with parallel screws (21.4%), intermediate with FNS (12.9%), and lowest with Alpha fixation (9.6%). Multivariate analysis showed significantly lower fixation failure with Alpha fixation compared to parallel screws (adjusted OR = 0.29, 95% CI: 0.10-0.73, p = 0.014). Alpha fixation significantly reduced femoral neck shortening (p = 0.017), whereas FNS significantly reduced varus collapse (p = 0.013). In Pauwels type III fractures, Alpha fixation and FNS both significantly reduced fixation failure rates compared to parallel screws; no difference was found in Pauwels types I-II.

conclusionsAlpha fixation and FNS significantly outperformed parallel screws in reducing fixation failure in vertical femoral neck fractures among nongeriatric patients. Alpha fixation showed advantages in limiting femoral neck shortening, whereas FNS more effectively prevented varus collapse. For stable fractures, conventional parallel screws remain a reasonable choice.

Indexed as

Bone ScrewsFemoral Neck FracturesFracture Fixation, InternalAdolescentAdultAgedFemaleHumansMaleMiddle AgedReoperationRetrospective StudiesTreatment OutcomeYoung AdultAlpha fixationFemoral neck fractureFemoral neck systemFixation failureNongeriatric

Identifiers

PMID41117917
PMCPMC12662912

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.