Comparison Of Short-term Curative Effect Between FNS And CCS In The Treatment Of Garden Type Ⅲ And Ⅳ Femoral Neck Fractures In Young And Middle-aged Patients

Objective: To investigate the short-term clinical effect of Femoral Neck System(FNS)and Cannulated Compression Screw(CCS)internal fixation in the treatment of young and middle-aged Garden Ⅲ and Ⅳ femoral neck fractures(FNF).Methods:A total of 44 patients who underwent internal fixation of FNF with FNS or CCS from January 2020 to December 2020 in Zunyi First People’s Hospital were retrospectively analyzed.According to the difference of treatment scheme,the patients were divided into 18 cases in FNS group and 26 cases in CCS group.The general clinical data,intraoperative evaluation indicators,and early postoperative evaluation indicators of the patients were observed and recorded,and postoperative follow-up and efficacy evaluation were performed to analyze the short-term clinical efficacy of the two surgical methods.Results: There were no significant differences between the FNS group and the CCS group in terms of gender,age,Body mass index(BMI),comorbidities,injury factors,injury side,Garden classification,and time from injury to operation(P>0.05).There was no significant difference in the average operation time,blood loss,incision length,assisted reduction or not,and fracture reduction quality(Garden index)between the two groups(P>0.05).Compared with partial weight bearing and complete weight bearing time,the FNS group was significantly shorter than the CCS group(P<0.05).The pain in the two groups was obvious within 24 hours after operation,and the pain was significantly relieved at 72 hours after operation,and the degree of postoperative pain in the two groups was the similar(P>0.05).There were no early postoperative complications in the two groups,and The average hospital stay and treatment satisfaction were similar(P>0.05).Each patient was followed up for at least 12 months after operation,and no nonunion,avascular necrosis of the femoral head and internal fixation failure occurred.The clinical healing time of postoperative fractures in the two groups was similar(P>0.05).At the 12 th month of follow-up,the shortened length of the femoral neck in the two groups was(2.89±1.91)mm in the FNS group and(6.00±2.15)mm in the CCS group,and the average shortened length of the femoral neck in the FNS group was smaller(P<0.05).The changes of the neck-shaft angle in the two groups were(1.33±1.46)° in the FNS group and(3.35±1.79)°in the CCS group,and the change in the neck-shaft angle in the FNS group was smaller(P<0.05).The Harris score of hip joint in both groups showed that postoperative hip joint function gradually improved from good to excellent,and compared with the CCS group,the functional improvement of the hip joint in the FNS group was better(P<0.05).Conclusion: Both FNS and CCS internal fixation have good safety and clinical efficacy in the treatment of young and middle-aged FNF in the short term,and FNS has more obvious advantages and stronger stability,and can significantly reduce the shortening of the femoral neck and the change of the neck-shaft angle.The improvement of hip joint function is more obvious,and it is an effective solution for the treatment of young and middle-aged FNF.