• Zhe Zheng Clyde Lim, Cheryl Marise Peilin Tan, Antony XavierRex PremchandRPDepartment of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore., Michael Gui Jie Yam, and ChuaIvan Tjun HuatITHDepartment of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore..
• Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
• Singapore Med J. 2024 Jan 8.

IntroductionThe femoral neck system (FNS) is a safe alternative to cannulated compression screw (CCS) and dynamic hip screw (DHS) in femoral neck fractures.MethodsA dual-centre retrospective cohort study was performed on femoral neck fractures (AO type 31-B) treated with closed reduction and internal fixation using FNS, DHS or CCS between April 2016 and April 2020. Exclusion criteria were as follows: patients aged below 16 years; chronic fractures beyond 7 days; pathological fractures; fracture extension to the intertrochanteric region or ipsilateral neck and shaft fractures; and open fractures. A total of 85 patients were identified: FNS (n = 28), DHS (n = 29) and CCS (n = 28).ResultsThe FNS and CCS groups had a lower Garden and Pauwels classification compared to the DHS group (both P < 0.001). Both FNS and CCS groups were comparable in postoperative orthopaedic complications (10.7% [n = 3] vs. 3.6% [n = 1], adjusted P = 0.321). The DHS group had more postoperative orthopaedic complications than the FNS group, but this was not statistically significant (27.6% [n = 8] vs. 10.7% [n = 3], adjusted P = 0.321). There were no significant differences in median time to radiological union or median femoral neck shortening at union (both P > 0.05) among the three groups.ConclusionThe new DePuy Synthes FNS is a safe alternative to CCS with comparable complication rates for femoral neck fractures that are less displaced and more stable. The FNS also appears to be a safe alternative to DHS in the fixation of femoral neck fractures for the few cases of high-energy femoral neck fractures.Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.

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