Cannulated screw fixation assisted by a self-designed guide for the treatment of Garden stage I-III femoral neck fracture: A retrospective case-series study

Abstract Purpose: To explore the effects of a self-designed Kirschner wire guiding and adjustment apparatus for internal fixation with cannulated screws for the treatment of femoral neck fracture. Methods: We retrospectively reviewed the patients with femoral neck fracture (Garden I-III) treated at our hospital between 01/2018 and 3/2022. The cases were included in the present study according to the inclusion and exclusion criteria. The operation time, The times of provisional Kirschner wires(K-wires) insertion, times of fluoroscopy , estimated blood loss in operation, Harris score, and VAS score of the hip joint were recorded and analyzed. Results: Forty patients were included (13 females and 17 males, (median, 58 years of age), with 20 patients in the unguided and 20 in the guided groups, respectively. Their body mass index (BMI) was 23.03±1.86 kg/m2. Compared with the unguided group, the guided group showed shorter operation time (median 0.20 vs. 0.43 h, P<0.001), less blood loss (median, 2 vs. 20 mL, P<0.001), less Insertion times of Kirschner wire (median, 7 vs. 15, P<0.001) and fluoroscopy times (median 12 vs. 20, P<0.001). The VAS score (median, 1vs. 1, P=0.359)and Harris score (92.75±4.83 vs. 89.75±5.20, P=0.066).shows no significant difference between groups at the final follow-up. Conclusions: Using theself-designed Kirschner wire guiding and adjustment apparatus during fixation of femoral neck fracture with cannulated screws reduces the operation time, blood loss, insertion times of Kirschner wire and fluoroscopy. This might promote the recovery of patients. Those results should be confirmed in further studies. Levels of Evidence: Level IV