Comparative study of femoral neck shortening following two types of internal fixation in young and middle-aged patients with displaced femoral neck fractures

By
Yun He
Yiliyaer Abudusimu
Guosheng Wang
Bin Xu
Tayierjiang Yasheng
May 11, 2026
0 min

Frontiers In Surgery

Overview

This study compares femoral neck shortening outcomes in young and middle-aged patients with displaced femoral neck fractures treated with two internal fixation techniques: the Femoral Neck System (FNS) and FNS combined with Cannulated Compression Screws (CCS). Results indicate that while the combined technique reduces femoral neck shortening, it requires longer operative time and greater blood loss.

Background

Femoral neck fractures are a significant orthopedic concern, particularly in young and middle-aged adults, representing a small but critical subset of hip fractures. The choice of internal fixation method is crucial, as it impacts recovery and complication rates. Understanding the comparative effectiveness of different fixation techniques is essential for optimizing patient outcomes.

Data Highlights

Parameter	FNS Group	Combined Group	P-value
Operative Time (min)	81 (76, 92)	142 (112, 152)	< 0.05
Intraoperative Blood Loss (mL)	56 (51, 66)	86 (77, 92)	< 0.05
Femoral Neck Shortening at 3 months (mm)	3.04 ± 0.68	1.58 ± 0.32	< 0.05
Femoral Neck Shortening at 9 months (mm)	3.98 ± 0.30	2.65 ± 0.52	< 0.05
Femoral Neck Shortening at 15 months (mm)	4.62 ± 1.09	2.88 ± 0.79	< 0.05

Key Findings

No significant differences in demographic and clinical characteristics between the two groups.
The combined group had a significantly longer operative time and greater intraoperative blood loss compared to the FNS group.
Femoral neck shortening was significantly less in the combined group at 3, 9, and 15 months postoperatively.
No significant differences in reduction quality, postoperative hospital stay, hip Harris score, or complication rates between the two groups.
Surgeons should consider the trade-offs between surgical complexity and outcomes when selecting fixation techniques.

Clinical Implications

Surgeons must weigh the benefits of reduced femoral neck shortening against the increased operative time and blood loss associated with the combined fixation technique. Tailoring the surgical approach to individual patient circumstances is essential for optimizing outcomes.

Conclusion

The study highlights that while FNS combined with CCS can effectively reduce femoral neck shortening, it demands higher surgical expertise and resources. Careful consideration of the surgical method is crucial in managing displaced femoral neck fractures.