scholarly journals Biomechanical study of different internal fixations in Pauwels type III femoral neck fracture - A finite elements analysis

2020 ◽  
Author(s):  
Anderson Freitas ◽  
Joubert Vieira Toledo Júnior ◽  
Adeni Ferreira dos Santos ◽  
Rubén Jeri Aquino ◽  
Vitor Negreiro Leão ◽  
...  
Keyword(s):  
Finite Elements ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Biomechanical Study ◽  
Finite Elements Analysis ◽  
Type Iii ◽  
Neck Fracture

Modified F Configuration in the Treatment of Pauwels Type III Femoral Neck Fracture: a Finite Element Analysis

2021 ◽  
Author(s):  
Shiyuan Lin ◽  
Huizi Li ◽  
Kai Tong ◽  
Zihang Feng ◽  
Gang Wang ◽  
...  
Keyword(s):  
Finite Element ◽  
Stress Distribution ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Type Iii ◽  
Neck Fracture ◽  
Maximum Crack ◽  
Hip Screw

Abstract Background: The optimal treatment of Pauwels type III femoral neck fracture in young patients remains a worldwide challenge in orthopedic surgery. Methods: Finite element models of four internal fixations were developed to treat Pauwels type III Femoral neck fracture: a: the traditional inverted triangular cannulated screw model, b: the F-technique cannulated screw model, c: the modified F-technique cannulated screw model using a fully threaded screw instead of a partially threaded distally, d: the dynamic hip screw coupled with anti-rotational screw model. Under the same conditions, finite element analyses were carried out to compare the displacement and von Mises stress distribution of four internal fixations and femurs, the maximum crack distances of the fracture surfaces, Z axis displacements of four models as well as the stress distribution in the subtrochanteric region. Results: The modified F-technique configuration resulted in a more stable fixation as compared to the other three approaches, with respect to the maximum displacement and stress peaks of femur and internal fixations, the maximum crack distances of the fracture surfaces, Z axis displacements of four configurations as well as the stress distribution in the subtrochanteric region.Conclusions: Our results suggested that modified F-technique configuration show a better performance in resisting shearing and rotational forces in treating Pauwels type III femoral neck fractures compared to those using traditional inverted triangular, the F-technique configuration or dynamic hip screw coupled with anti-rotational screw, providing a new choice for the treatment of femoral neck fractures.

scholarly journals Non-Traumatic Tile Type B3 Pelvic Fracture Combined With Garden Type III Femoral Neck Fracture Caused By Hypocalcaemia-Induced Convulsions

2021 ◽  
Author(s):  
Minghan Dou ◽  
Guangkai Ren ◽  
Baoming Yuan ◽  
Chuangang Peng ◽  
Dankai Wu
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Pelvic Fracture ◽  
Pelvic Fractures ◽  
Maintenance Hemodialysis ◽  
Tile Type ◽  
Conventional Radiograph ◽  
Type Iii ◽  
Neck Fracture

Abstract BACKGROUND Non-traumatic fractures caused by convulsions are relatively rare and are often overlooked due to the lack of obvious evidence of injury. Non-traumatic fractures due to convulsions are diverse, but the concomitant of pelvic and femoral fractures has not been reported previously. CASE SUMMARY A 47-year-old woman with a no significant medical history, was taken to the nearest hospital after one episode of generalized tonic-clonic seizure that had occurred during sleep. After the postictal phase, the patient regained consciousness and experienced diffuse pain in the inguinal regions bilaterally with inability to stand or walk. The entire attack was witnessed by the family members who confirmed that there was not external trauma. Blood investigations revealed high creatinine and uric acid levels, along with a low calcium level. Conventional radiograph of the pelvis was performed to detect the cause of pain. The patient was noted to have a pelvic fracture and unilateral fracture of the neck of the femur. She was then transferred to our hospital for further management. The patient was diagnosed as having Tile type B3 pelvic fractures combined with a Garden type III femoral neck fracture on three-dimensional computed tomography (3D-CT). In view of her blood results, nephrology consultation was sought. The patient was identified as having a stage 5 chronic kidney disease (CKD), hypocalcemia, and hyperphosphatemia. However, neurological examination showed no abnormalities. No surgical intervention was adopted for her pelvic fractures. In addition to complete bed rest, closed reduction and percutaneous cannulated screw fixation was performed for the treatment of the right femoral neck fracture. An arteriovenous fistula was created for maintenance hemodialysis on the tenth postoperative day. At follow-up, twelve months follow-up after the operation, the patient had a normally gait and was satisfied with the outcome. CONCLUSION Patients who present with convulsive seizures especially patients with ion metabolism disorder should be examined thoroughly to ensure that no injury is missed.

scholarly journals Pauwels screw combined inverted triangle cannulated screws for the treatment of Pauwels type-III femoral neck fracture:- a new surgical method based on the morphology of the fracture

2020 ◽  
Author(s):  
Gang Xue ◽  
Siting Chen ◽  
Maosheng Zhou ◽  
Zhengyu Wang ◽  
Liangliang Wan ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Cannulated Screws ◽  
Type Iii ◽  
Operative Duration ◽  
Neck Fracture ◽  
Flexion And Extension

Abstract Background: Femoral neck fracture is a serious injury in adults with significant functional consequences.Internal fixtion is an established treatment for femoral neck fractures in young adult patients .However, the risk of complications following fixation has plague orthopedists for decades.In all femoral neck fracture ,Pauwels type-III femoral neck fractures with a large vertical shear force were more likely to cause clinical failure.The aim of this study is to intruduce a new surgical technique for the treatment of this fracture according to the morphology of the fracture using the combination of Pauwels screw and inverted triangle cannulated screws(PSTCS)，and report the clinical effects in a prospective cohort of 14 patients.Methods: From June 2017 to June 2019, a total of 14 patients (8 males and 6 females ) with Pauwels type-III femoral neck fracture underwent the surgical treatment of PSTCS according to the morphologyical types of fracture in clinical operation in our department. Patients were allowed to perform contraction exercises of quadriceps femoris on postoperative day1, passive flexion and extension exercises postoperative day 2 onwards, and active flexion and extension exercises postoperative day 7 onwards. Patients were allowed for partial-weight bearing walking postoperative 1month onwards with axillary crutches. After one month AP and lateral radiograph were taken. Full ambulation was permitted until the presence of radiological consolidation.Intraoperative (Operative duration,Blood loss),postoperation(Fracture union time,The Harris Hip Score,Visual analog score) were record for comparison.Results: All patients were followed up for at least 12 months.In the end point of the follow up ,12 of the 14 patients (85.7%)with pauwels type-III femoral neck fractures had achieved satisfactory hip function. Operative duration was a mean of 49.5 ±10.4 minutes.Intraoperative blood loss was between 26 and 110 ml (mean, 44.4±20.6ml) and without intraoperative blood transfusion . The Harris Hip Score was between 64 and 95(mean,87.6±8.9).Fracture healing was observed in all patients according to the X-ray . No internal fixation was loosened or screw cut-out in the follow-up period.The femoral head necrosis was observed in 1 patient in this study. In addition, there was no obvious fracture displacement, femoral neck shortening, or hip varus. Conclusions: The study showed that PSTCS can provide a satisfactory clinical outcomes for treatment of pauwels type-III femoral neck fractures.Most patients (85.7%) achieved good or excellent results with the use of PSTCS,which appears to be a reliable method and provides another choice for this problematic fracture.The new internal fixation method of PSTCS can provide mechanical stability and promote fracture healing

scholarly journals The role of the medial plate for Pauwels type III femoral neck fracture: a comparative mechanical study using two fixations with cannulated screws

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Vincenzo Giordano ◽  
Danilo Diniz Alves ◽  
Roger Pletsch Paes ◽  
Arthur Bonfim Amaral ◽  
Marcos Giordano ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Cannulated Screws ◽  
Type Iii ◽  
Mechanical Study ◽  
Neck Fracture

Proposal for a New Fixation Method for Pauwels Type III Femoral Neck Fracture-Metaphyseal Stem: A Finite-Element Analysis

2021 ◽  
Author(s):  
Anderson Freitas ◽  
Fabrício Reichert Barin ◽  
Leonardo Rigobello Battaglion ◽  
Hélio Ismael da Costa ◽  
Eduardo Duarte Santos ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Fixation Method ◽  
Element Analysis ◽  
Type Iii ◽  
Neck Fracture

scholarly journals Treatment of Pauwels type III femoral neck fracture with medial femoral neck support screw: a biomechanical and clinical study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhichao Gao ◽  
Mei Wang ◽  
Baojie Shen ◽  
Xiaodong Chu ◽  
Di Ruan
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Biomechanical Study ◽  
Femoral Head Necrosis ◽  
Vertical Shear ◽  
Control Group ◽  
Fixation Failure ◽  
Neck Fracture

AbstractA femoral neck fracture is currently one of the most common types of fracture in clinical practice. The incidence continues to increase due to traffic accidents, trauma, and osteoporosis. This research includes a biomechanical study and a clinical retrospective study. In the biomechanical studies, three groups’ effects (Control Group: 3CCS, DHS group, and study Group: 3CCS + mFNSS group) were compared by vertical compression tests, torsion tests, and fatigue tests. All the data were collected and analyzed. We subsequently performed a retrospective analysis of 131 patients with femoral neck fractures. The operative time, intraoperative blood loss, quality of postoperative fracture reduction, and follow-up observation of fracture healing, screw retreatment rates and fixation failure rates, as well as femoral head necrosis rates and hip function in two groups with 3CCS and 3CCS + mFNSS were compared. By the biomechanical study, we found that 3CCS + Mfnss group were biomechanically superior to 3CCS group and superior to the DHS group in terms of resistance to torsion. However, it was less effective than the DHS group in compressive strength and fatigue resistance. In terms of clinical application, 3CCS + mFNSS group was found to have lower screw retreatment rates and femoral head necrosis rates, and to have better fracture healing rates than group with 3CCS, indicating that medial support screws can effectively resist the vertical shear forces of fracture ends and promote the stability and healing of fracture ends, as well as to reduce the incidence of postoperative complications.

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