Finite element analysis of new headless compression supporting screw for the treatment of unstable femoral neck fracture
Source abstract
Abstract
BACKGROUND: Femoral neck fracture is an unsolved challenge in orthopedics. The complication rate in particular is high. There remains a lack of consensus on the optimal choice of internal fixation for unstable femoral neck fracture. OBJECTIVE: The study aimed to develop a new headless compression supporting screw (HCSS) for the treatment of unstable foemoral neck fracture. METHODS: We designed a new HCSS and used a femoral neck fracture (Pauwels III fracture) model (left, fourth-generation composite, Sawbones) and three-dimensional finite element analysis to compare the biomechanical performance of HCSSs with that of cannulated compression screws (CCSs) for treatment of unstable femoral neck fracture. RESULTS: Maximum displacement, peak von Mises stress, peak strain, and rotation for the HCSS were smaller than those for the CCS. The stress was more widely distributed for the HCSS, whereas the stress was concentrated for the CCS. CONCLUSIONS: The HCSS resulted in better biomechanical stability than that from the CCS. For Pauwels III fractures the HCSS exhibits better resistance to shear forces and better support, providing a new clinical treatment.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Hip and Femur Fractures · Bone health and osteoporosis research · Bone fractures and treatments
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
, Beijing LuHe Hospital Affiliated to Capital Medical University, , China
, Nantong University, , China
References (32)
Show source-provided references
1. Epidemiology of femoral neck fractures10.1016/S0020-1383(02)00324-8 ↗
2. Results of internal fixation of Pauwels type-3 vertical femoral neck fractures10.2106/JBJS.G.01353 ↗
3. Risk factors for nonunion in patients with intracapsular femoral neck fractures treated with three cannulated screws placed in either a triangle or an inverted triangle configuration10.2106/JBJS.K.01081 ↗
4. Pauwels’ classification of femoral neck fractures: Correct interpretation of the original10.1097/00005131-200106000-00009 ↗
5. Complications following young femoral neck fractures10.1016/j.injury.2014.10.010 ↗
6. The clinical application of a novel method of internal fixation for femoral neck fractures-dynamic locking compression system10.1186/s13018-018-0827-9 ↗
7. The management of intracapsular fractures of the proximal femur10.1302/0301-620X.82B7.0820937 ↗
8. Biomechanical analysis of augmented plate fixation for the treatment of vertical shear femoral neck fractures10.1097/BOT.0000000000000205 ↗
9. Analysis of risk factors for femoral head necrosis after internal fixation in femoral neck fractures10.3928/01477447-20141124-60 ↗
10. Structural properties of fourth-generation composite femurs and tibias10.1016/j.jbiomech.2008.08.013 ↗
11. Mechanical evaluation of large-size fourth-generation composite femur and tibia models10.1007/s10439-009-9887-7 ↗
12. Treatment of femoral neck fractures in patients 45–64 years of age10.1016/j.injury.2018.11.020 ↗
13. A biomechanical comparison of two triple-screw methods for femoral neck fracture fixation in a synthetic bone model
14. Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures: A biomechanical study10.1016/S0020-1383(03)00059-7 ↗
15. Clinical and economic impact of using generic 7.3-mm cannulated screws at a level II trauma center
16. Fatigue testing of a new locking plate for hip fractures10.5405/jmbe.826 ↗
17. Biomechanical evaluation of the expansive cannulated screw for fixation of femoral neck fractures10.1016/j.injury.2011.07.004 ↗
18. The complications of displaced intracapsular fractures of the hip10.1302/0301-620X.87B11.17089 ↗
19. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly10.1016/j.injury.2014.12.031 ↗
20. A biomechanical investigation of the human hip10.1016/0021-9290(78)90045-3 ↗
21. Intracapsular femoral neck fractures: The importance of early reduction and stable osteosynthesis10.1016/S0020-1383(02)00330-3 ↗
22. Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures10.3944/AOTT.2014.3159 ↗
23. Incidence, magnitude, and predictors of shortening in young femoral neck fractures10.1097/BOT.0000000000000351 ↗
24. Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC)10.1016/j.injury.2017.06.013 ↗
25. The effect of shortening and varus collapse of the femoral neck on function after fixation of intracapsular fracture of the hip: a multi-centre cohort study10.1302/0301-620X.90B11.20582 ↗
26. Vertically oriented femoral neck fractures: Mechanical analysis of four fixation techniques10.1097/BOT.0b013e31814b822e ↗
27. Efficacy comparison between dynamic hip screw combined with anti-rotation screw and cannulated screw in treating femoral neck fractures
28. Multiple cannulated screws vs. dynamic hip screws for femoral neck fractures10.1007/s00132-017-3473-8 ↗
29. The effect of interlocking parallel screws in subcapital femoral-neck fracture fixation: A cadaver study10.1016/j.clinbiomech.2013.11.008 ↗
30. Locking plates and their effects on healing conditions and stress distribution: A femoral neck fracture study in cadavers10.1016/j.clinbiomech.2014.03.006 ↗
31. Augmentation by cerclage wire improves fixation of vertical shear femoral neck fractures-A biomechanical analysis10.1016/j.injury.2016.07.030 ↗
32. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis10.1186/s13018-019-1097-x ↗