Evidence map›Paper›PMID 41391133›Full record

ArticleJoint diseases and related surgery2026

Bicortical screw placement and microdamage in medial buttress plates in the management of Pauwels type III femoral neck fractures: A scanning electron microscopy-based analysis.

Osman Gorkem Muratoglu, Cem Yildirim, Hasan Ceylan, Yinal Neşes Huvaj, Mehmet Demirel, Süreyya Ergün Bozdağ

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Article in Joint diseases and related surgery, 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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5 · Who and what money

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6 authors.

Osman Gorkem Muratoglu
Cem YildirimCam ve Sakura Şehir Hastanesi, Ortopedi ve Travmatoloji Kliniği, 34480 Başakşehir, İstanbul, Türkiye. cemyildirim701@hotmail.com.
Hasan Ceylan
Yinal Neşes Huvaj
Mehmet Demirel
Süreyya Ergün Bozdağ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aims to investigate the microstructural effects of distal bicortical screw placement in medial buttress plate (MBP) constructs using scanning electron microscopy (SEM). MATERIALS AND

methodsTen synthetic femur models with standardized Pauwels type III fractures were divided into two groups. All specimens received fixation with three cannulated screws in an inverted triangle configuration. Group A received a MBP fixed with four unicortical screws. Group B received the same construct, except for the most distal screw was inserted bicortically. All specimens underwent combined axial and torsional cyclic loading, followed by load-to-failure testing. Plates were, then, analyzed under SEM to assess deformation and microdamage. A semi-quantitative scoring system was used to compare the severity of microstructural changes between groups.

resultsThe SEM analysis revealed significantly more microdamage in Group B compared to Group A (median deformation scores: 4 vs. 2; p=0.0181). Plates with bicortical screw placement showed localized plastic deformation, microcracks, and in some cases, complete fractures, particularly at the bent midsection of the plate. In contrast, unicortical plates showed only mild surface irregularities without structural failure.

conclusionAlthough distal bicortical screw placement may enhance initial mechanical stability, it also increases the risk of microstructural damage in MBPs, potentially compromising long-term durability. These findings underscore the importance of optimizing screw configuration to balance stability with implant longevity in the treatment of vertically unstable femoral neck fractures.

Indexed as

Bone PlatesBone ScrewsFemoral Neck FracturesFracture Fixation, InternalMicroscopy, Electron, ScanningBiomechanical PhenomenaHumansMaterials TestingProsthesis DesignStress, MechanicalWeight-Bearing

Identifiers

PMID41391133
PMCPMC12788761

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.