{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:38:19Z","timestamp":1792427899141,"version":"4.5.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016355","name":"Xuzhou Science and Technology Bureau","doi-asserted-by":"publisher","award":["KC22037"],"award-info":[{"award-number":["KC22037"]}],"id":[{"id":"10.13039\/501100016355","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal method for internal fixation of femoral neck fractures in younger individuals remains a subject of debate. This meta-analysis systematically evaluates and compares the clinical outcomes of the femoral neck system (FNS) and cannulated compression screws (CCSs) within this demographic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive literature search was conducted across the Cochrane Library, PubMed, Web of Science, and Embase databases, covering studies from their inception through March 2024. The search targeted cohort studies that compared FNS (<jats:italic>n<\/jats:italic>\u2009=\u2009265) and CCSs (<jats:italic>n<\/jats:italic>\u2009=\u2009326) in patients aged 14\u201365\u2005years with femoral neck fractures. The methodological quality of the studies was appraised using the Newcastle\u2013Ottawa Scale. Statistical analyses were executed using RevMan 5.4, with results presented as standardized mean differences (SMDs) or weighted mean differences (WMDs), accompanied by 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis incorporated nine high-quality cohort studies involving 591 patients who underwent surgical procedures for femoral neck fractures. Of these patients, 265 were treated with the femoral neck system (FNS), while 326 were treated with CCSs. Meta-analysis revealed that, compared to CCS, FNS was associated with a significantly shorted fracture healing time (SMD\u2009=\u200916.30, 95% CI: 3.79\u201328.82, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), decreased intraoperative fluoroscopy usage (WMD)\u2009=\u2009\u22128.14, 95% CI: \u22129.82 to \u22126.46, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), and higher Harris hip scores at the final follow-up (WMD\u2009=\u2009\u22123.43, 95% CI: \u22124.08 to \u22122.77, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001). In addition, the FNS group exhibited a lower incidence of postoperative complications, including urinary tract infections, venous thromboembolism, non-union, screw loosening, and femoral head necrosis [risk ratio (RR)\u2009=\u20091.05, 95% CI: 0.92\u20131.19, <jats:italic>P<\/jats:italic>\u2009=\u20090.50]. However, the FNS was associated with a longer surgical incision (WMD\u2009=\u20090.84, 95% CI: 0.55\u20131.13, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) and increased intraoperative blood loss (WMD\u2009=\u200916.30, 95% CI: 3.79\u201328.82, <jats:italic>P<\/jats:italic>\u2009=\u20090.01). The analysis revealed no statistically significant differences between the two techniques in terms of operation duration (WMD\u2009=\u2009\u22124.88, 95% CI: \u221212.25 to 2.48, <jats:italic>P<\/jats:italic>\u2009=\u20090.19), length of hospital stay (WMD\u2009=\u20090.10, 95% CI: \u22120.20 to 0.40, <jats:italic>P<\/jats:italic>\u2009=\u20090.52), or the excellent-to-good rate at the final follow-up (RR\u2009=\u20091.05, 95% CI: 0.92\u20131.19, <jats:italic>P<\/jats:italic>\u2009=\u20090.50).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The femoral neck system (FNS) may present potential benefits in specific outcomes, notably expedited healing and enhanced functional rehabilitation. The results of this study advocate for the consideration of the FNS as a preferred treatment option for active patients, where minimizing radiation exposure and optimizing long-term outcomes are prioritized, despite its slightly greater invasiveness.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1626320","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T05:28:31Z","timestamp":1759987711000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparative efficacy of femoral neck system vs. cannulated compression screws in young patients with femoral neck fractures: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Weishuai","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nannan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianyou","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuchao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.12200\/j.issn.1003-0034.2023.03.017","article-title":"Interpretations of management of hip fractures in older adults: evidence-based clinical practice guideline adopted by AAOS 2021","volume":"36","author":"Gao","year":"2023","journal-title":"Zhongguo Gu Shang"},{"key":"B2","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1097\/BOT.0000000000002828","article-title":"Optimal fixation strategies for displaced femoral neck fractures in patients 18\u201359 years of age: an analysis of 565 cases treated at 26 level 1 trauma centers","volume":"38","author":"Roser","year":"2024","journal-title":"J Orthop Trauma"},{"key":"B3","doi-asserted-by":"publisher","first-page":"102497","DOI":"10.1016\/j.jcot.2024.102497","article-title":"A recent update on the fixation techniques for femoral neck fractures: a narrative review","volume":"54","author":"Kim","year":"2024","journal-title":"J Clin Orthop Trauma"},{"key":"B4","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jor.2024.06.010","article-title":"Two-year outcomes of internal fixation with femoral neck system in patients with femoral neck fracture in an Asian population","volume":"57","author":"Chan","year":"2024","journal-title":"J Orthop"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3207","DOI":"10.1007\/s00590-024-04051-0","article-title":"Comparison of femoral neck system versus cannulated cancellous screws for the fixation of femoral neck fracture: a single-center retrospective cohort study","volume":"34","author":"Caldaria","year":"2024","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e34582","DOI":"10.1016\/j.heliyon.2024.e34582","article-title":"Comparison of three different internal fixation methods in the treatment of femoral neck fracture","volume":"10","author":"Zhang","year":"2024","journal-title":"Heliyon"},{"key":"B7","doi-asserted-by":"publisher","first-page":"110842","DOI":"10.1016\/j.injury.2023.110842","article-title":"What makes vertical femoral neck fracture with posterior inferior comminution different? 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