Femoral neck system interferes less with the gluteus medius muscle than cannulated compression screws in patients with Pauwels' type III femoral neck fracture: a retrospective study of 103 cases

Abstract

Abstract Background The femoral neck system (FNS) shows promise as an effective alternative for treating femoral neck fractures, particularly Pauwels type III fractures. However, limited literature exists on comparative studies investigating the effects of FNS versus cannulated compression screws (CCS) on the gluteus medius (GM) muscle. This study aims to compare the impact of FNS and CCS interventions on the GM in Pauwels type III femoral neck fracture treatment. Methods This study included 103 patients diagnosed with Pauwels type III femoral neck fractures, treated between January 2019 and September 2021. Among them, 54 patients underwent FNS treatment (FNS group), while 49 patients received CCS fixation (CCS group). Changes in GM area were assessed through ultrasound at 3 and 6 months postoperatively, and hip function was assessed by Harris hip score. Results At 3-, and 6-months post-surgery, the GM area was notably reduced on the operated side in the CCS group compared to the healthy side (p < 0.0001), while no significant disparity was observed in the FNS group (p = 0.402 at 3 months, p = 0.989 at 6 months). The Harris hip score, reflecting postoperative recovery, was significantly superior in the FNS group compared to the CCS group both in March (84.5 ± 3.9 vs. 82.7 ± 4.4, P = 0.029) and June (91.4 ± 4.4 vs. 89.7 ± 4.0, P = 0.037). Conclusion FNS internal fixation for Pauwels type III femoral neck fractures minimally impacts the GM compared to compression screws, suggesting its potential to improve hip function, facilitate gait, and enhance overall hip joint rehabilitation.