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Novel screw fixation placement configuration for the treatment of Pauwels type III femoral neck fractures: a finite element analysis

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Abstract

Verticality of transcervical hip fractures in young patients is usually connected with typically high-energy fractures which are known as Pauwels type III. Artificial femoral head replacement surgery is mostly not considered for treating femoral neck fractures in such patients. The commonly used devices for the fixation of vertical femoral neck fractures are multiple screws or a sliding hip screw with or without an antirotation screw. Size, location and length of the screws are the most effective parameters in terms of the structural performance of internal fixation implants, but the optimal configuration of the screws is necessary to be investigated to direct the clinical practice. The aim of this study is to compare the biomechanical stability of the standard inverted triangle configuration with the various newly proposed x-crossed screw configurations. FEA simulations carried out in this study demonstrated that using an x-crossed-right assembly in treating Pauwels type III femoral neck fractures satisfies the biomechanical stability in terms of maximum von Mises stresses and maximum femoral head displacement. However, in terms of maximum relative neck fracture displacement, the x-crossed-right assembly would not entirely suffice the desired biomechanical stability. Therefore, using an x-crossed screw assembly in treating femoral neck fractures would provide the needed biomechanical stability.

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Authors and Affiliations

  1. Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Ivana Lučića 5, 10000, Zagreb, Croatia

    Petra Adamović & Janoš Kodvanj

  2. Department of Traumatology, Sestre Milosrdnice University Hospital Center, Draškovićeva 19, 10000, Zagreb, Croatia

    Dejan Blažević & Srećko Sabalić

  3. University of Applied Health Sciences, Mlinarska Cesta 38, 10000, Zagreb, Croatia

    Dejan Blažević

  4. School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia

    Srećko Sabalić

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  1. Petra Adamović
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Correspondence to Petra Adamović.

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Adamović, P., Kodvanj, J., Blažević, D. et al. Novel screw fixation placement configuration for the treatment of Pauwels type III femoral neck fractures: a finite element analysis. Med Biol Eng Comput 61, 1005–1015 (2023). https://doi.org/10.1007/s11517-023-02771-9

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  • DOI: https://doi.org/10.1007/s11517-023-02771-9

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