Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture

Background The incidence of femoral neck fracture is increasing as society ages. Different types of cannulated screws can be used for internal fixation of femoral neck fractures, but no screw selection protocol has been determined to reduce the risk of operation failure. This retrospective study aim...

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Main Authors: Ko-Ta Chen MD, Hsien-Tsung Lu MD, PhD, Chian-Her Lee MD, Meng-Huang Wu MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Geriatric Orthopaedic Surgery & Rehabilitation
Online Access:https://doi.org/10.1177/21514593251330580
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author Ko-Ta Chen MD
Hsien-Tsung Lu MD, PhD
Chian-Her Lee MD
Meng-Huang Wu MD, PhD
author_facet Ko-Ta Chen MD
Hsien-Tsung Lu MD, PhD
Chian-Her Lee MD
Meng-Huang Wu MD, PhD
author_sort Ko-Ta Chen MD
collection DOAJ
description Background The incidence of femoral neck fracture is increasing as society ages. Different types of cannulated screws can be used for internal fixation of femoral neck fractures, but no screw selection protocol has been determined to reduce the risk of operation failure. This retrospective study aimed to elucidate differences in outcomes between using cannulated compression screws and headless compression screws for fixation in nondisplaced femoral neck fractures. Methods Adults aged 18 years and older with non-displaced femoral neck fracture, admitted between February 2016 and January 2022, and received fixation using three screws in an inverted triangle configuration were selected for this retrospective study. After exclusions, patients were separated into four groups based on using different combinations of headed cannulated compression screws and headless compression screws. Postoperative computerized tomography or magnetic resonance imaging was used to evaluate operation failure, defined as nonunion or avascular necrosis of the femoral head. Results After exclusions, 153 patients (median age 75.0, range 65.0-85.0) with majority of females (69.9%) were included. While the combination of one cannulated compression screw (CCS) and two headless compression screws (HCS) did not achieve statistical significance compared to other screw configurations ( P = 0.073), it still demonstrated the lowest rate of operative failure (0.0%). Age was identified as the only significant factor associated with operative failure (adjusted OR: 1.10; 95% CI: 1.03-1.17; P = 0.004). Conclusions No significant differences are found in outcomes between different combinations of cannulated headed compression screws and headless compression screws in an inverted triangle configuration for fixation of non-displaced femoral neck fractures.
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spelling doaj-art-df2a5205303c40aa9687ae0328a9b76e2025-08-20T01:48:28ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932025-03-011610.1177/21514593251330580Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck FractureKo-Ta Chen MDHsien-Tsung Lu MD, PhDChian-Her Lee MDMeng-Huang Wu MD, PhDBackground The incidence of femoral neck fracture is increasing as society ages. Different types of cannulated screws can be used for internal fixation of femoral neck fractures, but no screw selection protocol has been determined to reduce the risk of operation failure. This retrospective study aimed to elucidate differences in outcomes between using cannulated compression screws and headless compression screws for fixation in nondisplaced femoral neck fractures. Methods Adults aged 18 years and older with non-displaced femoral neck fracture, admitted between February 2016 and January 2022, and received fixation using three screws in an inverted triangle configuration were selected for this retrospective study. After exclusions, patients were separated into four groups based on using different combinations of headed cannulated compression screws and headless compression screws. Postoperative computerized tomography or magnetic resonance imaging was used to evaluate operation failure, defined as nonunion or avascular necrosis of the femoral head. Results After exclusions, 153 patients (median age 75.0, range 65.0-85.0) with majority of females (69.9%) were included. While the combination of one cannulated compression screw (CCS) and two headless compression screws (HCS) did not achieve statistical significance compared to other screw configurations ( P = 0.073), it still demonstrated the lowest rate of operative failure (0.0%). Age was identified as the only significant factor associated with operative failure (adjusted OR: 1.10; 95% CI: 1.03-1.17; P = 0.004). Conclusions No significant differences are found in outcomes between different combinations of cannulated headed compression screws and headless compression screws in an inverted triangle configuration for fixation of non-displaced femoral neck fractures.https://doi.org/10.1177/21514593251330580
spellingShingle Ko-Ta Chen MD
Hsien-Tsung Lu MD, PhD
Chian-Her Lee MD
Meng-Huang Wu MD, PhD
Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture
Geriatric Orthopaedic Surgery & Rehabilitation
title Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture
title_full Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture
title_fullStr Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture
title_full_unstemmed Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture
title_short Outcomes of Headed and Headless Cannulated Screws Fixation in Nondisplaced Femoral Neck Fracture
title_sort outcomes of headed and headless cannulated screws fixation in nondisplaced femoral neck fracture
url https://doi.org/10.1177/21514593251330580
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