Comparison of nonanatomical reduction of femoral neck fractures in young patients treated with femoral neck system: a retrospective cohort study

Abstract

Purpose Negative buttress reduction should be avoided in the treatment of femoral neck fractures (FNFs) using conventional implant devices. As the femoral neck system (FNS) has been recently developed and utilized widely to treat FNFs, the clinical efficacy of reduction quality has not been clarified. The purpose of this study was to evaluate clinical effects of nonanatomical reduction in young FNFs treated with FNS. Methods This multicenter, retrospective cohort study included 58 patients diagnosed as FNFs between September 2019 and December 2021. According to radiographs immediate following surgery, reduction quality were classified into positive, anatomical and negative buttress reduction groups. Assessment of postoperative hip function using Harris hip scores (HHS) system and postoperative complication rate was performed. Logistic regression model was used to analyses risk factors. Results Postoperative complication rate and Harris hip scores showed no significant difference in groups (P ＞0.05). Adjusted smoking status [OR = 1.991, 95%CI (1.063, 3.698)], Pauwels classification [OR = 2.012, 95%CI (1.216, 4.325)] were independent risk factors for postoperative complications. Compared with anatomical reduction, negative buttress reduction [OR = 2.987, 95%CI (1.101, 6.337)] was found to be significantly associated with complications after surgery in femoral neck fractures treated with FNS. Conclusion Negative buttress reduction should be constantly avoided in young FNFs treated with FNS or conventional implant devices.