ArticleJournal of orthopaedic surgery and research2021
Enhanced interfragmentary stability and improved clinical prognosis with use of the off-axis screw technique to treat vertical femoral neck fractures in nongeriatric patients.
Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Parallel versus non-parallel cannulated screw fixation for femoral neck fractures: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- Pooled it
- Compressive buttress compared with off-axial screw fixation for vertical femoral neck fractures in young adults: a prospective, randomized controlled trial.Journal of orthopaedic surgery and research · 2024Trial
- Clinical outcomes of femoral neck fractures in nongeriatric patients: a comparative analysis of parallel screws, alpha fixation and femoral neck system.International orthopaedics · 2025Article
- Finite element analysis of sliding vs static configuration of partial threaded cannulated compression screws for Pauwels type III fracture neck of femur.Journal of clinical orthopaedics and trauma · 2025Article
- Biomechanical properties of off-axis screw in the treatment of vertical femoral neck fractures: a finite element analysis.BMC musculoskeletal disorders · 2025Article
- [Effectiveness of guide plate with mortise-tenon joint structure combined with off-axis fixation in treatment of Pauwels typeZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Effect of screw thread type on implant-related complications following femoral neck fracture fixation in non-geriatric adults: a multicenter, retrospective cohort study.Frontiers in surgery · 2025Article
- Article
- [Comparison of effectiveness of three surgical methods in treatment of Pauwels typeZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Article
- Biomechanical analysis of a new cannulated screw for unstable femoral neck fractures.Frontiers in bioengineering and biotechnology · 2024Article
- Comparison of augmentation effects of medial buttress plate versus trochanteric lag screw in the cannulated screw fixation of Pauwels type III femoral neck fractures: A retrospective clinical study.Acta orthopaedica et traumatologica turcica · 2023Article
- Nine-year-long complex humeral nonunion salvaged by distraction osteogenesis technique: a case report and review of the literature.BMC surgery · 2022Review
- The Effect of Vertical and Oblique Inclinations on Fracture Stability and Reoperation Risks in Femoral-Neck Fractures of Nongeriatric Patient.Frontiers in bioengineering and biotechnology · 2021Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe optimal internal fixation strategy for vertical femoral neck fractures (VFNFs) in nongeriatric patients remains uncertain. Therefore, the purpose of this study was to compare the clinical prognoses and underlying mechanical characteristics of a novel off-axis screw technique with dynamic hip screws (DHSs) and three traditional parallel screws.
methodsThis study included a clinical investigation and a patient-specific finite element analysis (FEA). In the clinical investigation, VFNF patients were grouped by fixation type: (1) use of three parallel screws (G-TRI); (2) augmentation with an off-axis screw (G-ALP); and (3) DHS with an anti-rotational screw (G-DHS). Fixation failures (nonunion, femoral neck shortening (FNS), varus deformation, screw cut-out) and avascular necrosis (AVN) consequent to the three types of fixations were compared. In the FEA, twenty-four fixation models with the three fixation types were created based on the data of eight healthy volunteers. Models were assessed under walking conditions. Stiffness, interfragmentary motion (IFM), and implant stress were evaluated.
resultsIn the clinical investigation, the fixation failure rate was significantly (p < 0.05) lower in G-ALP (18.5%) than in G-DHS (37.5%) and G-TRI (39.3%). No significant difference in AVN was observed among the three fixation groups. In the FEA, stiffness and implant stress in the G-DHS models were significantly (p < 0.05) higher, and the IFM of G-ALP was significantly (p < 0.05) lower among the groups.
conclusionsAmong fixation types for VFNFs, the off-axis screw technique exhibited better interfragmentary stability (lowest IFM) and a lower fixation failure rate (especially FNS). Analyzing interfragmentary stability in biomechanical experiments is more consistent with clinical prognosis than construct stability for VFNFs, suggesting that internal fixations should aim for this outcome.
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