Femoral neck system with an additional cannulated screw for the treatment of elderly femoral neck fractures: a retrospective study.

Objective: To compare the clinical efficacy of the femoral neck system (FNS) alone versus FNS combined with an additional cannulated compression screw (CCS) for treating elderly patients (aged 65-75) with Garden I-III femoral neck fractures. Methods: This retrospective study analyzed 126 patients treated between January 2020 and December 2022. Patients were divided into an FNS group (n = 60) and an FNS+CCS group (n = 66). Key outcomes included operative time, intraoperative blood loss, fluoroscopy frequency, fracture healing time, femoral neck shortening, complications, VAS pain scores, and Harris hip scores at final follow-up. Results: The two groups showed no significant differences in baseline characteristics. While intraoperative blood loss was comparable, the FNS+CCS group had significantly longer operative times and required more fluoroscopies. All patients were followed for an average of 14.1 months. The FNS+CCS group demonstrated a significantly shorter fracture healing time and a lower incidence of femoral neck shortening at final follow-up. Although VAS scores were similar between groups, the FNS+CCS group achieved significantly higher Harris hip scores. The incidence of complications did not differ significantly. Conclusion: For elderly patients with femoral neck fractures, FNS fixation augmented with a CCS offers significant advantages over FNS alone, including accelerated fracture healing and superior functional recovery of the hip joint, despite a longer operative time.