Functional and Quality of Life Outcomes After Cannulated Cancellous Screw Fixation of Femoral Neck Fractures in Young Adults: A Prospective Study

Background: Femoral neck fractures in young adults are commonly associated with high-energy trauma and remain a significant orthopedic challenge because of complications such as non-union, avascular necrosis (AVN), and impaired functional recovery. Cannulated cancellous screw (CCS) fixation is widely used for preservation of the native femoral head; however, limited studies have evaluated both functional outcome and health-related quality of life (HRQoL) following this procedure. Materials and Methods: This prospective cohort study was conducted from June 2023 to May 2024. Fifty patients aged 18–50 years with femoral neck fractures treated with CCSs were included. Functional outcomes were assessed using the modified Harris Hip Score (HHS), while HRQoL was evaluated using the EuroQol-5D (EQ-5D) questionnaire. Patients were followed up at 6 weeks, 3 months, and 6 months postoperatively. Complications including infection, screw loosening, non-union, and AVN were also recorded. Results: The mean age of patients was 37.68 ± 8.0 years, with male predominance (66%). Road traffic accidents were the most common mode of injury (50%). The mean HHS improved significantly from 70.06 ± 6.4 at 6 weeks to 81.94 ± 5.6 at 6 months ( P < 0.001). EQ-5D scores demonstrated significant improvement across all domains during follow-up ( P < 0.001). The mean EQ Visual Analog Scale score at final follow-up was 89.4 ± 3.7. Postoperative complications included infection in 12% of patients, screw loosening in 6%, nonunion in 6%, and AVN in 6%. Conclusion: CCS fixation provides satisfactory functional recovery and significant improvement in HRQoL in young adults with femoral neck fractures, with acceptable complication rates. It remains an effective treatment option for preservation of the native hip joint in younger patients.