Comparative study of fully threaded and partially threaded cancellous cannulated screws versus partially threaded cancellous cannulated screws in femoral neck fractures in adults

Background: Femoral neck fractures constitute a significant portion of orthopaedic trauma, with intra-capsular fractures representing 50% of all hip fractures, their incidence is projected to rise dramatically due to the aging population. These fractures, particularly in the elderly, lead to high morbidity and mortality. Optimal surgical treatment for femoral neck fractures remains debated, especially in younger adults. Methods: This hospital-based prospective comparative study was conducted over one year. Patients aged 18-60 years with femoral neck fractures were randomized into two groups: Group A were operated using combination of fully threaded and partially threaded cancellous cannulated screws and group B using partially threaded cancellous cannulated screws. Functional outcomes were assessed using the Harris hip score (HHS) and visual analog scale (VAS) for pain, and radiological union times were recorded. Complications such as non-union, screw back-out, and infection were also evaluated. Results: The study included 30 patients, with 15 in each group. Group A showed significantly better HHS at 6 months (88.53±7.46) compared to group B (77.69±13.35) (p<0.05). VAS scores were lower in group A, indicating less pain, though the difference was not statistically significant. Radiological union time was shorter in group A (12.55±2.39 weeks) compared to group B (13.89±5.29 weeks) (p<0.05). Group A had fewer complications, with no cases of screw back-out compared to four in group B. Conclusions: The combination of fully threaded and partially threaded cancellous cannulated screws when used appropriately offers better functional outcomes, faster radiological union, and fewer complications compared to partially threaded screws alone in femoral neck fractures in young adults.