الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Background: A displaced femoral neck fracture (FNF) in a young adult is still an unsolved problem with considerable debate and represents a great challenge for orthopedic surgeons. Literature shows that when using DHS or cannulated screws, the most commonly used implants, there is a high chance of post-operative complications such as avascular necrosis, non-union, and fixation failure leading to unacceptable high rate of 2ry reoperation. A 2015 meta-analysis of 41 studies regarding young femoral neck fractures found a reoperation rate of 20% after internal fixation of isolated femoral neck fractures, with AVN (14.35%) and nonunion (9.3%) being the most common complications leading to repeat surgeries.
Aim of the Work: To compare the clinical outcomes, radiological outcomes and complications of dynamic locking plates and cannulated screws augmented with anteromedial buttress plates in treating fracture neck femur in adults less than 60 years old.
Materials and Methods: This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Literature was searched till 31 December 2022 using Web of Science, PubMed, and Cochrane databases. A search was performed for all published articles in English using the following keywords “femoral neck system” , “FNS” , “femoral neck fracture” and “femoral neck system”, “femoral neck fracture” and ”medial plate”, “femoral neck fracture” and” buttress plate”.
Results: According to this review, the reporting FNS studies had mean age 51.4 years with male percentage 58%, displaced fracture was 81%. The weighted mean Operation time 62 min mean and blood loss was 73ml. The weighted mean postoperative HHS was 89. Nonunion occurred in 2.6%, AVN occurred in 1.3%, Femoral neck shortening in 9.5% and Cut out or implant failure 2.6% The reporting CS augmented with anteromedial femoral neck plate studies had mean age of 40.5 years with male percentage 70%, displaced fracture was 100%. The weighted mean Operation time 82 min and mean blood loss was 196 ml. The weighted mean postoperative HHS was 90. Nonunion occurred in 6.5%, AVN occurred in 3.2%, femoral neck shortening in 6.3% and Cut out or implant failure 4%. There was statistically significant difference in blood loss and operation time, but there was no statistically significant difference in postoperative HHS, Nonunion, AVN, Femoral neck shortening and Cut out or implant failure.
Conclusion: Femoral neck system (FNS) and cannulated screws combined with antero-medial femoral neck plates have no significant difference in nonunion rate, AVN rate and femoral neck shortening rate with almost similar Harris Hip score. However, Femoral neck system (FNS) has significantly less blood loss and operation time compared to cannulated screws combined with medial plates.