Abstract
BACKGROUND: Femoral neck fracture (FNF) is a common injury in both elderly and young population, often resulting from low- and high-energy trauma, respectively. The femoral neck system (FNS), a novel fixed-angle device, has recently emerged as a promising implant offering multiple biomechanical advantages over conventional fixation methods. The purpose of this study is to evaluate the clinical and radiological outcomes of FNS in managing FNFs in an Indian population. METHODS: This prospective observational study was conducted at SKIMS Medical College, Srinagar, from February 2022 to February 2025 involving 40 skeletally mature patients with FNFs treated using FNS. Patients were followed-up for a minimum of 12 months and a maximum of 30 months, with majority (22) of the patients being followed-up for full 30 months. Four out of forty operated patients were lost to follow-up. Clinical outcomes were assessed using the Harris Hip Score (HHS), whilst radiological union was evaluated with the Radiographic Union Score for Hip (RUSH). Intra-operative parameters, fracture morphology, time to union, and complications were also recorded. RESULTS: Thirty-six patients completed follow-up. Mean time to union was 15.37 weeks, mean RUSH score was 27.75, and mean HHS was 95.08. Radiological union was achieved in 34 cases, with one case each of delayed union and non-union with avascular necrosis. Smoking and medial cortex comminution were significantly associated with delayed union. The device demonstrated low complication rates, minimal blood loss, and reduced operative time. CONCLUSION: The FNS offers effective fixation for FNFs with excellent intermediate-term clinical and radiological outcomes in the Indian population. Its biomechanical stability and minimally invasive approach make it a viable option, though long-term results remain to be established.