Femoral neck system for the treatment of intracapsular femoral neck fractures in patients <65 years

Abstract

Introduction: The femoral neck system (FNS) (DePuy Synthes) for intracapsular femoral neck fractures is designed with superior angular and rotational stability incorporated into a single system. Our objective is to qualitatively review and describe the technical details and outcomes regarding use of this implant in young hip fracture patients. Methods: In a review of consecutive FNS surgeries in five local hospitals (QMH, PMH, AHNH, TKOA, GHK) from June 2020 to March 2021, 19 patients under the age of 65 (28-64) with intracapsular neck fractures (9 un-displaced, 10 displaced) were identified. Reduction techniques (open vs closed), surgical quality (TAD, reduction and implant positioning), clinical and radiological outcomes are qualitatively reported and discussed. Results: One patient (GHK case) required open reduction and 9 were reduced closed. Cortical stepping of >4 mm and retroversion >5 degrees were observed in 4 and 2, respectively. 14 achieved definite healing with cortical remodelling at an average of 18.9 weeks follow-up. Remaining 3 patients had no cortical remodelling between 7 and 39 weeks. One had failure of fixation requiring conversion to a total hip arthroplasty. The average collapse is 3.8 mm (range -2.5 to 14.8). Of the 19 patients, 8 regained unaided outdoor functional walking status before 13 weeks. The technical advantages and difficulties are to be discussed. Discussion and Conclusion: The early results of the FNS are promising in young hip fractures. Larger studies with longer observation periods are needed.