Femoral Neck System: A Review of the Literature

Internal fixation of femoral neck fractures typically involves three parallel cannulated screws (3CS) and sliding hip screws (SHS). The Femoral Neck System (FNS) was developed to replicate the minimally invasive nature and short operative time of 3CS while maintaining the biomechanical strength of SHS. A literature search was conducted using Ovid MEDLINE, PubMED, Cochrane, and ClinicalTrials.gov to find relevant literature which ultimately resulted in 17 included studies. FNS may provide be!er biomechanical properties compared to 3CS and similar biomechanics compared to SHS for femoral neck fractures. Patient reported outcomes between the three constructs as well as overall complications may be similar. FNS is a safe and effective treatment modality for internal fixation of femoral neck fractures in younger, middle-aged, and older adults; however, it is considerably more expensive than 3CS and SHS. More clinical and biomechanical trials comparing FNS to SHS are warranted. (Journal of Surgical Orthopaedic Advances 35(1):001 – 009, 2026)

Key words: femoral neck system, femoral neck fracture, garden fracture, pauwels fracture, internal fixation, literature review