To explore the relationship between different configurations of hollow nails and hip joint function after femoral neck fracture surgery.

A total of 158 young and middle-aged femoral neck fracture patients who underwent hollow screw internal fixation in our hospital from October 2015 to August 2019 were selected. According to the number and configuration of hollow screws, they were divided into a normal triangle group, an inverted triangle group, and a quadrilateral group. The follow-up time was more than half a year. The operation time, blood loss, number of fluoroscopies, hospitalization time, time to partial weight bearing and fracture healing, Harris score of the hip joint, and postoperative complications were recorded and compared among the three groups.

There were no significant differences in intraoperative blood loss, hospital stay, and time to fracture healing among the three groups (P＞0.05), and the average follow-up time was (20.77±7.84) months. The operation time of the patients in the normal triangle group, inverted triangle group, and quadrilateral group were (57.84±13.44), (53.77±10.56) and (79.45±11.65) min, respectively; the number of fluoroscopies was (19.22±7.85), (18.49±9.46) and (27.82±7.66) times. The operation time was significantly longer and the number of fluoroscopies was significantly more in the quadrilateral group than in the other two groups (P＜0.05), but there was no statistical difference between the normal triangle group and the inverted triangle group (P＞0.05). The time to weight-bearing was significantly shorter in the quadrilateral group [(9.27±1.88) weeks] than in the other two groups [normal triangle gorup: (12.06±1.47) weeks, inverted triangle group: (11.87±1.55) weeks; P＜0.05], though there was no statistical difference between the normal triangle group and the inverted triangle group (P＞0.05). The Harris scores of patients in the normal triangle group, inverted triangle group, and quadrilateral group were (71.26±7.52), (75.45±6.89), and (82.79±6.76), respectively, at 3 months after surgery; the score of the quadrilateral group was significantly higher than those of the other two groups (P＜0.05), while there was no statistically significant difference between the normal triangle group and the inverted triangle group (P＞0.05). There was no significant difference in Harris score or total complication rate among the three groups at the last follow-up (P＞0.05).

The clinical effect of hollow screws in the treatment of femoral neck fractures in young and middle-aged patients is definite, and the configuration and number of screws have no significant effect on fracture healing and long-term hip joint function.