The Probability of And Risk Factors For Femoral Neck Shortening And Internal Fixation Failure After Femoral Neck Fracture Treatment Using Cannulated Screws Combined With A Medial Buttress Plate

Background: Femoral neck shortening and internal fixation failure are two most prevalent complications associated with surgical treatment of femoral neck fracture. This study evaluates the probability of and risk factors for these complications after the treatment of femoral neck fracture using cannulated screws combined with a medial buttress plate.Methods: Data of 70 patients with femoral neck fractures treated using cannulated screws combined with a medial buttress plate in our hospital between March 2016 and March 2019 were retrospectively analyzed, and 40 patients who were followed up for no less than 6 months were enrolled in the study. We evaluated the probability of postoperative femoral neck shortening and internal fixation failure and conducted multivariate logistic regression analysis to determine risk factors.Results: Among 40 patients, 11 had femoral neck shortening＞5 mm and 8 had fracture nonunion or screw cutout. There were significant differences in screw quality between the shortening and non-shortening groups; There were significant differences in fracture site and shortening between the fixation failure and non-failure groups. According to the multivariate analysis, screw quality was an independent risk factor for femoral neck shortening (odds ratio [OR]: 8.58; 95% confidence interval [CI]: 1.35–50.57; P=0.022), and femoral neck shortening was an independent risk factor for internal fixation failure (OR: 11.82; 95% CI: 1.66–84.36; P=0.014).Conclusions: Femoral neck fracture treatment using cannulated screws combined with a medial buttress plate led to a femoral neck shortening rate lower than that of other internal fixation methods and an internal fixation failure rate lower than or equivalent to that of other internal fixation methods. The quality of cannulated screws is a risk factor for postoperative shortening of the femoral neck, and femoral neck shortening is a risk factor for postoperative internal fixation failure.