ArticleInternational orthopaedics2018
Screw-blade fixation systems in Pauwels three femoral neck fractures: a biomechanical evaluation.
Article in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Cement augmentation for trochanteric femur fractures: A meta-analysis of randomized clinical trials and observational studies.PloS one · 2021Pooled it
- Biomechanical Evaluation of Internal Fixation of Pauwels Type III Femoral Neck Fractures: A Systematic Review of Various Fixation Methods.Clinics in orthopedic surgery · 2019Pooled it
- Comparison of dynamic hip screw with anti-rotation screw and femoral neck system internal fixation for the treatment of garden II-IV type femoral neck fractures.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Trial
- Exploring the Effectiveness of "Four-Point" Configuration Cannulated Compression Screw Implantation Protocol for the Fixation of Pauwels Type III Femoral Neck Fractures in Adults.Orthopaedic surgery · 2026Article
- Anti-Shortening Screw for the Prevention of Postoperative Shortening in Displaced Femoral Neck Fractures: A Retrospective Cohort Study.Orthopaedic surgery · 2024Article
- Finite Element Analysis of Six Internal Fixations in the Treatment of Pauwels Type III Femoral Neck Fracture.Orthopaedic surgery · 2024Article
- Exploring the displacement characteristics of Garden III femoral neck fractures and the reliability, validity, and value of the anteroposterior Garden Index in assessing displacement severity.Journal of orthopaedic surgery and research · 2023Article
- The incidence of focal osteonecrosis of the femoral head and its impact on conversion hip arthroplasty after screw fixation of femoral neck fractures: a multicenter retrospective study based on postoperative magnetic resonance imaging.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Review
- Combined Deflection Angle Classification: A Novel Typing System of Adult Femoral Neck Fracture.Orthopaedic surgery · 2023Article
- Biomechanical evaluation of two modified intramedullary fixation system for treating unstable femoral neck fractures: A finite element analysis.Frontiers in bioengineering and biotechnology · 2023Article
- High Percentage of Complications and Re-Operations Following Dynamic Locking Plate Fixation with the TargonMedicina (Kaunas, Lithuania) · 2022Article
- Impact of Anterior Malposition and Bone Cement Augmentation on the Fixation Strength of Cephalic Intramedullary Nail Head Elements.Medicina (Kaunas, Lithuania) · 2022Article
- Evaluation of a Locking Autocompression Screw Model in Pauwels Type-3 Femoral Neck Fracture: In Vitro Analysis.Bioengineering (Basel, Switzerland) · 2022Article
- [Research progress in biomechanics of common internal fixation for femoral neck fracture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
- Biomechanical comparison of the femoral neck system versus InterTan nail and three cannulated screws for unstable Pauwels type III femoral neck fracture.Biomedical engineering online · 2022Article
- Mechanical effects of surgical variations in the femoral neck system on Pauwels type III femoral neck fracture : a finite element analysis.Bone & joint research · 2022Article
- Biomechanical and clinical evaluation of interlocking hip screw in Pauwels Ⅲ femoral neck fractures: A comparison with inverted triangle cannulated screws.Frontiers in bioengineering and biotechnology · 2022Article
- Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws.Medicina (Kaunas, Lithuania) · 2021Article
- Intracapsular Femoral Neck Fractures-A Surgical Management Algorithm.Medicina (Kaunas, Lithuania) · 2021Review
- Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels II.Journal of orthopaedic translation · 2020Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo reduce mechanical complications after osteosynthesis of femoral neck fractures, improved fixation techniques have been developed including blade or screw-anchor devices. This biomechanical study compares different fixation systems used for treatment of unstable femoral neck fractures with evaluation of failure mode, load to failure, stiffness, femoral head rotation, femoral neck shortening and femoral head migration.
methodsStandardized Pauwels type 3 fractures (AO/OTA 31-B2) with comminution were created in 18 biomechanical sawbones using a custom-made sawguide. Fractures were stabilized using either SHS-Screw, SHS-Blade or Rotationally Stable Screw-Anchor (RoSA). Femurs were positioned in 25 degrees adduction and ten degrees posterior flexion and were cyclically loaded with an axial sinusoidal loading pattern of 0.5 Hz, starting with 300 N, with an increase by 300 N every 2000 cycles until bone-implant failure occurred.
resultsMean failure load for the Screw-Anchor fixation (RoSA) was 5100 N (IQR 750 N), 3900 N (IQR 75 N) for SHS-Blade and 3000 N (IQR 675 N; p = 0.002) for SHS-Screw. For SHS-Screw and SHS-Blade we observed fracture displacement with consecutive fracture collapse as the main reason for failure, whereas RoSA mainly showed a cut-out under high loadings. Mean stiffness at 1800 N was 826 (IQR 431) N/mm for SHS-Screw, 1328 (IQR 441) N/mm for SHS-Blade and 1953 (IQR 617) N/mm for RoSA (p = 0.003). With a load of 1800 N (SHS-Screw 12° vs. SHS-Blade 7° vs. RoSA 2°; p = 0.003) and with 2700 N (24° vs. 15° vs. 3°; p = 0.002) the RoSA implants demonstrated a higher rotational stability and had the lowest femoral neck shortening (p = 0.002), compared with the SHS groups. At the 2700 N load point, RoSA systems showed a lower axial (p = 0.019) and cranial (p = 0.031) femoral head migration compared to the SHS-Screw.
conclusionsIn our study, the new Screw-Anchor fixation (RoSA) was superior to the comparable SHS implants regarding rotational stability and femoral neck shortening. Failure load, stiffness, femoral head migration, and resistance to fracture displacement were in RoSA implants higher than in SHS-Screws, but without significance in comparison to SHS-Blades.
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