Femoral neck system vs conventional fixation: Long-term outcomes from a single-center study

The Femoral Neck System (FNS) is a minimally invasive fixation device for femoral neck fractures, but its comparative long-term performance versus conventional fixation remains debated.

In this single-center retrospective study (Jan 2020-Oct 2022) all patients treated surgically for femoral neck fractures were included. Primary outcomes were operative time, peri-operative bleeding, fixation failure, avascular necrosis, reoperation, mortality, and autonomy using Parker score. A multivariable logistic regression assessed risk of postoperative loss of autonomy. FNS results were compared to a large multicenter series from the literature.

total of 143 patients (mean age 78.7 ± 13.8 years; 58.7 % women) were included and grouped by implant: 31 FNS, 62 triple cannulated screws, 50 dynamic hip screw (DHS). Operative time differed across groups with DHS being the longest. Peri-operative bleeding, fixation failure, infection, and mortality did not differ significantly between groups. In adjusted analysis, each additional year of age increased the risk of postoperative loss of autonomy by 5.1 % independently of the surgical system. Mean follow-up was approximately two years enabling detection of later complications.

FNS provided outcomes broadly comparable to conventional fixation with shorter operative time than DHS. Given the older, more displaced case-mix and longer follow-up, cautious interpretation is warranted. Age emerged as the strongest predictor of functional outcome.