ArticleChinese journal of traumatology = Zhonghua chuang shang za zhi2026
Identification of optimal screws positions for internal fixation of femoral neck fracture: A simulation study based on femoral neck safe zone.
Article in Chinese journal of traumatology = Zhonghua chuang shang za zhi, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeIt is often difficult for surgeons to accurately implant the cannulated screws for fixing femoral neck fractures under C-arm fluoroscopy. Our simulation study attempts to help surgeons identify the optimal positions of screws on anteroposterior and lateral radiographs.
methodsA retrospective study including patients from 2014.01.01 to 2017.12.31 was conducted. Softwares were used for 3-dimensional reconstruction and cross-sections construction of 60 femoral necks. The contours of all cross-sections along the axis of the femoral neck were stacked to identify a safe zone for screws placement. A simulation experiment was carried out with 3 circles of diameter 6.5 mm in the safe zone. The absolute and relative positions of every screw in the anteroposterior radiographs and lateral radiographs were measured Normal distribution, continuous data are presented in mean ± standard deviation, and analyzed by t-test. The category data are presented by n (%) and analyzed by the Chi-square test.
resultsThe morphologies of the safe zones for screws placement were anteriorly flat ellipses. The best dispersion was obtained with the inverted triangle shape in this zone: the inferior was positioned near the lower 1/10 on the anteroposterior view and near the anterior 3/5 on the lateral view. The anterosuperior and posteriosuperior screws were positioned near the upper 1/5 and 1/4, respectively, on the anteroposterior view, and near the anterior 1/10 and posterior 1/5, respectively, on the lateral view.
conclusionSimulated screws implantation demonstrates the distribution characteristics of screws in anteroposterior and lateral radiographs. This can help decrease the risk of perforation and iatrogenic injury.
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