Anterior positioning screw in proximal femoral plating restricts posterior tilt of retroverted femoral neck fractures: a retrospective cohort study

Abstract Background Preoperative posterior tilt is a risk factor for fixation failure in femoral neck fractures. This study aimed to evaluate the configuration of anterior positioning screw proximal plating treatment retroverted fractures terms resisting tilt. Methods We retrospectively analyzed patients with who were fixed by from January 2014 August 2019. All divided into two groups according configuration: long-threaded (ALTS, n = 36) and normally short-threaded screws (NTS, 46). Baseline characteristics reviewed radiological clinical outcomes analyzed. Logistic regression analysis was used identify factors developing Results Age, gender, Garden classification, comminution, reduction quality showed no significant difference between groups. Increased lower ALTS group (3.2°, 2.1–4.3°) than that NTS (5.3°, 4.2–8.3°) ( p < 0.001), percentage people > 5° also (5, 13.9% vs. 24, 52.2%; 0.001). Femoral shortening (FNS) (3.1 (2.1–4.7) mm 4.3 (3.1–6.3) mm, 0.003), though not statistically when using 5 as cut-off value. Harris Hip Score higher (87.0, 84.0–90.0 82.0, 76.0–84.5; Postoperative complications including delayed union, nonunion, avascular necrosis comparable Multivariable identified comminution (OR 15.9, 95% CI 3.6–70.3, suboptimal 12.0, 2.6–56.1, 0.002), (reference: configuration) 21.9, 4.1–116.4, 0.001) Conclusions Configuration provides better resistance against Also, reduction, ALTS) are Trial registration The trial number ChiCTR2000039482 .