A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures

Abstract Femoral neck fractures (FNF) are a significant concern, particularly in elderly patients with osteoporosis and younger individuals experiencing high-energy traumas. Traditional treatments, like cannulated compression screws (CCSs), often result in complications such as avascular necrosis (A...

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Main Authors: Dewei Zhao, Yu Zhang, Liangliang Cheng, Zhijie Ma, Feng Wang, Xing Qiu, Jiawei Ying, Tianwei Zhang, Fuyang Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04188-w
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author Dewei Zhao
Yu Zhang
Liangliang Cheng
Zhijie Ma
Feng Wang
Xing Qiu
Jiawei Ying
Tianwei Zhang
Fuyang Wang
author_facet Dewei Zhao
Yu Zhang
Liangliang Cheng
Zhijie Ma
Feng Wang
Xing Qiu
Jiawei Ying
Tianwei Zhang
Fuyang Wang
author_sort Dewei Zhao
collection DOAJ
description Abstract Femoral neck fractures (FNF) are a significant concern, particularly in elderly patients with osteoporosis and younger individuals experiencing high-energy traumas. Traditional treatments, like cannulated compression screws (CCSs), often result in complications such as avascular necrosis (AVN). This study evaluated the effectiveness of bidirectional compression porous tantalum screws (BCPTSs) against conventional CCSs in FNF treatment. A retrospective study was conducted on 109 patients with FNF treated at Zhongshan Hospital, Dalian University, from January 2016 to December 2020. Patients were divided into three groups based on the fixation method: two CCSs, three CCSs, and BCPTSs. Postoperative outcomes were assessed using anteroposterior radiographs, with follow-up evaluations at six weeks, three months, 12 months, and 24 months. Diabetic patients were also included as subjects of observation to analyze the association between postoperative osteonecrosis and diabetes. In the two CCSs group, seven patients (7/20, 35%) experienced AVN, compared to 17 patients (17/39, 43.58%) in the three CCSs group. In contrast, only one patient (1/50, 2%) in the BCPTSs group developed nonunion, with no cases of AVN. In a comparison among diabetic patients, there was one case of postoperative AVN in the two CCSs group, five cases in three CCSs group, and one case of fracture nonunion in the BCPTSs group. BCPTSs offer a superior alternative to conventional CCSs in treating FNF, particularly in reducing AVN and nonunion rates. The study highlights the importance of vascular preservation and contributes a new option for treating FNF.
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spelling doaj-art-1f2d051bf5604d09bd2eb4b8e6fbe1de2025-08-20T03:26:42ZengNature PortfolioScientific Reports2045-23222025-06-011511910.1038/s41598-025-04188-wA comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fracturesDewei Zhao0Yu Zhang1Liangliang Cheng2Zhijie Ma3Feng Wang4Xing Qiu5Jiawei Ying6Tianwei Zhang7Fuyang Wang8Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Orthopaedics, Affiliated Zhongshan Hospital of Dalian UniversityAbstract Femoral neck fractures (FNF) are a significant concern, particularly in elderly patients with osteoporosis and younger individuals experiencing high-energy traumas. Traditional treatments, like cannulated compression screws (CCSs), often result in complications such as avascular necrosis (AVN). This study evaluated the effectiveness of bidirectional compression porous tantalum screws (BCPTSs) against conventional CCSs in FNF treatment. A retrospective study was conducted on 109 patients with FNF treated at Zhongshan Hospital, Dalian University, from January 2016 to December 2020. Patients were divided into three groups based on the fixation method: two CCSs, three CCSs, and BCPTSs. Postoperative outcomes were assessed using anteroposterior radiographs, with follow-up evaluations at six weeks, three months, 12 months, and 24 months. Diabetic patients were also included as subjects of observation to analyze the association between postoperative osteonecrosis and diabetes. In the two CCSs group, seven patients (7/20, 35%) experienced AVN, compared to 17 patients (17/39, 43.58%) in the three CCSs group. In contrast, only one patient (1/50, 2%) in the BCPTSs group developed nonunion, with no cases of AVN. In a comparison among diabetic patients, there was one case of postoperative AVN in the two CCSs group, five cases in three CCSs group, and one case of fracture nonunion in the BCPTSs group. BCPTSs offer a superior alternative to conventional CCSs in treating FNF, particularly in reducing AVN and nonunion rates. The study highlights the importance of vascular preservation and contributes a new option for treating FNF.https://doi.org/10.1038/s41598-025-04188-wFemoral neck fracturePorous tantalum screwsAvascular necrosisDiabetes
spellingShingle Dewei Zhao
Yu Zhang
Liangliang Cheng
Zhijie Ma
Feng Wang
Xing Qiu
Jiawei Ying
Tianwei Zhang
Fuyang Wang
A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
Scientific Reports
Femoral neck fracture
Porous tantalum screws
Avascular necrosis
Diabetes
title A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
title_full A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
title_fullStr A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
title_full_unstemmed A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
title_short A comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
title_sort comparative study of internal fixation with porous tantalum screws and cannulated screws in the treatment of femoral neck fractures
topic Femoral neck fracture
Porous tantalum screws
Avascular necrosis
Diabetes
url https://doi.org/10.1038/s41598-025-04188-w
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