Clinical Outcomes of the Cephalomedullary Nail with Supplementary Screws versus Multiple Cannulated Screws for Femoral Neck Fracture in Young and Active Patients.

PURPOSE: Several studies have compared various methods of treatment for displaced femoral neck fractures (FNF), including multiple cannulated screw fixation, in young and active patients. However, there have been few studies on the cephalomedullary nail with additional cannulated screw fixation in displaced FNF. Therefore, the aim of this study is to evaluate the outcomes of the cephalomedullary nail technique with either a cannulated screw or multiple cannulated screw fixation in displaced FNF.

MATERIALS AND

METHODS

Among 69 consecutive patients who underwent internal fixation for displaced FNF, 64 were included. Patients were divided into two groups. Patients in Group 1 underwent fixation utilizing a cephalomedullary nail with an additional screw. Group 2 patients underwent fixation utilizing a cephalomedullary nail with additional multiple cannulated screws. Radiologic and clinical outcomes were assessed at the final follow-up clinical appointment.

RESULTS

No significant difference was found in basic characteristics such as mean age, male to female ratio, and fracture classification between the study groups. The mean time to ambulation after surgery was significantly shorter in Group 1 (P<0.001). There was no statistically significant difference between the two groups in procedure-specific complication rate. However, the immobilization-related complication rate was significantly higher in Group 2 (P=0.017).

CONCLUSION

In terms of enabling early ambulation in young and active patients, the cephalomedullary nailing with additional cannulated screws has the advantage in the management of displaced FNF. Furthermore, early ambulation lowers the rate of immobilization-related complications and shortens hospital stays.