Femoral Neck System: A Review of the Literature

Internal fixation of femoral neck fractures typically involves three parallel cannulated screws (3CS) and dynamic hip screws (DHS). The Femoral Neck System (FNS) was developed to replicate the minimally invasive nature and short operative time of 3CS while maintaining the biomechanical strength of DHS. A literature search was conducted using Ovid MEDLINE, PubMED, Cochrane, and ClinicalTrials.gov to find relevant literature which ultimately resulted in 17 included studies. FNS may provide better biomechanical properties compared to 3CS and similar biomechanics compared to DHS for femoral neck fractures. Patient reported outcomes between the three constructs as well as overall complications may be similar. FNS is a safe and effective treatment modality for internal fixation of femoral neck fractures in younger, middle-aged, and older adults; however, it is considerably more expensive than 3CS and DHS. More clinical and biomechanical trials comparing FNS to DHS are warranted. (Journal of Surgical Orthopaedic Advances 35(1):001-009, 2026).