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Meta-Analysis
. 2023 Jul;33(5):2101-2109.
doi: 10.1007/s00590-022-03407-8. Epub 2022 Oct 6.

The use of the femoral neck system (FNS) leads to better outcomes in the surgical management of femoral neck fractures in adults compared to fixation with cannulated screws: A systematic review and meta-analysis

Sandeep Patel  1 , Vishal Kumar  1 , Vishnu Baburaj  2 , Mandeep Singh Dhillon  1
Affiliations
Meta-Analysis

The use of the femoral neck system (FNS) leads to better outcomes in the surgical management of femoral neck fractures in adults compared to fixation with cannulated screws: A systematic review and meta-analysis

Sandeep Patel et al. Eur J Orthop Surg Traumatol. 2023 Jul.

Abstract

Background: Intracapsular femoral neck fractures are challenging to treat, with outcomes depending on the quality of reduction, and the stability of fixation. Cannulated cancellous screws (CCS) are the most commonly used implants to fix these fractures, but failure rates are significant. The recently introduced femoral neck system (FNS) may be a better option than CCS fixation and this review attempts to compare the results.

Methods: Four electronic databases were searched for eligible articles that had comparative data on the outcomes of fixation of adult femoral neck fractures with FNS and CCS. Data on various outcome parameters were collected. Meta-analysis was conducted using a random-effects model with 95% confidence intervals.

Results: Eight studies with 509 cases having a mean age of 50.8 years were included for final analysis. FNS was found to be associated with significantly reduced complication rates (p < 0.001), decreased incidence of postoperative femoral neck shortening (p < 0.001), quicker time to fracture union (p = 0.002), and better functional outcome scores (p < 0.001) compared to cannulated screws. FNS was also associated with a shorter operating time (mean difference 6.65 min) although not statistically significant (p = 0.24). CCS group had significantly reduced mean blood loss (p < 0.001).

Conclusion: The available literature supports FNS as a better option for adult femoral neck fractures, with a lower complication rate, quicker union, and better clinical outcomes.

Level of evidence: Level 3.

Keywords: CCS; Cannulated screws; FNS; Femoral neck fracture; Femoral neck system; Meta-analysis; Systematic review.

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