scholarly journals A comparative study of partial-threaded cannulated screws and double-threaded cannulated screws in the fixation of vertical femoral neck fractures

2020 ◽  
Author(s):  
Yuelei Zhang ◽  
Gang Wang ◽  
Wei Zhang
Keyword(s):  
Femoral Neck ◽  
Varus Deformity ◽  
Maximum Load ◽  
Femoral Neck Fractures ◽  
Vertical Shear ◽  
Axial Stiffness ◽  
Cannulated Screws ◽  
Fixation Failure ◽  
Fracture Displacement ◽  
Neck Fracture

Abstract Background This study purposed to compare the partial- threaded cannulated screws (PTCS) and the double-threaded cannulated screws (DTCS) in vertical shear femoral neck fractures both clinically and biomechanically. Methods Clinally, the radiographs of 81 patients with Pauwels Ⅲ femoral neck fractures, including 54 fractures fixed with PTCS and 27 fractures fixed with DTCS were analyzed. Complications consist of fixation failure (nail withdrawal, obvious fracture displacement, varus deformity or femoral neck shortening), bony nonunion and avascular necrosis (AVN) were determined. Biomechanically, twenty femur synthetic bones were equally divided and made to a vertical femoral neck fracture model, then fixed with three parallel PTCSs or DTCSs respectively. All specimens were tested for axial stiffness and a maximum load to failure with a loading rate of 2 mm/min. Results Clinically , 22 fractures in the PTCS group experienced fixation failure, including 19 nail withdrawal, 18 femoral neck shortening, 14 varus deformity and 8 obvious fracture displacement; while only 5 fractures showed up with fixation failure in the DTCS group, including 3 nail withdrawal, 4 femoral neck shortening, 4 varus deformity and 1 obvious fracture displacement. Additionally, 11 fractures in the PTCS group had nonunion while only 3 in the DTCS group and 9 fractures with AVN in the PTCS group while only 2 in the DTCS group. Biomechanically, The axial stiffness of DTCS was 152.89±22.74 N/mm, greater than PTCS (134.68±26.61), moreover, the failure load in DTCS was significantly greater than PTCS (1148.11±124.80 vs 795.88±162.50). Conclusion DTCS may exert more advantages than PTCS for vertical femoral neck fractures, including stronger fixation stability, lower rate of fixation failure and nonunion.

scholarly journals Comparison of Ordinary Cannulated Compression Screw and Double-Head Cannulated Compression Screw Fixation in Vertical Femoral Neck Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yuelei Zhang ◽  
Chao Yan ◽  
Lecheng Zhang ◽  
Wei Zhang ◽  
Gang Wang
Keyword(s):  
Femoral Neck ◽  
Maximum Load ◽  
Femoral Neck Fractures ◽  
Axial Stiffness ◽  
Screw Loosening ◽  
Compression Screw ◽  
Fixation Failure ◽  
Fracture Displacement ◽  
Load To Failure ◽  
Double Head

Background. The treatment of vertical femoral neck fractures in young patients remains a challenge. This study is aimed at comparing ordinary cannulated compression screw (OCCS) and double-head cannulated compression screw (DhCCS) fixation in vertical femoral neck fractures both clinically and biomechanically. Materials and Methods. Clinically, the radiographs of 81 patients with Pauwel’s III femoral neck fractures, including 54 fractures fixed with three parallel OCCSs and 27 fractures fixed with three parallel DhCCSs, were reviewed retrospectively. Complications consisting of fixation failure (screw loosening, obvious fracture displacement, varus deformity, or femoral neck shortening), bony nonunion, and avascular necrosis (AVN) were determined. Biomechanically, twenty synthetic femur models of vertical femoral fractures with an 80° Pauwel’s angle were divided into two groups and subsequently fixed with three parallel OCCSs or DhCCSs. All specimens were tested for axial stiffness, load to 5 mm displacement, and a maximum load to failure with a loading rate of 2 mm/min. Results. Clinically, 22 fractures in the OCCS group experienced fixation failure, including 19 screw loosening, 18 femoral neck shortening, 14 varus deformities, and 8 obvious fracture displacements, whereas only 4 fractures experienced fixation failure in the DhCCS group, including 3 screw loosening, 3 femoral neck shortening, 3 varus deformities, and 1 obvious fracture displacement. Additionally, 11 fractures in the OCCS group exhibited nonunion, whereas only 3 in the DhCCS group exhibited nonunion. Nine fractures with AVN were noted in the OCCS group, whereas only 1 was observed in the DhCCS group. Biomechanically, the axial stiffness of the DhCCS group was greater than that of the OCCS group ( 154.9 ± 6.81 vs. 128.1 ± 7.41  N/mm), and the load to 5 mm displacement was also significantly greater in the DhCCS group ( 646.1 ± 25.87 vs. 475.8 ± 21.46  N). Moreover, the maximum load to failure in the DhCCS group exhibited significant advantages compared with that of the OCCS group ( 1148 ± 39.47 vs. 795.9 ± 51.39  N). Conclusion. Our results suggested that using three DhCCSs improved the outcome of vertical femoral neck fractures compared to three OCCSs, offering a new choice for the treatment of femoral neck fracture.

FEMORAL NECK FRACTURE TREATED WITH CANNULATED SCREWS: IS REDUCTION THE KEY POINT?

2019 ◽  
Vol 22 (03n04) ◽  
pp. 1950010
Author(s):  
Emilio Enrietti ◽  
Alessandro Aprato ◽  
Lorenzo Bellomo ◽  
Alessandro Bistolfi ◽  
Luigi Sabatini ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Demographic Data ◽  
Lateral View ◽  
Femoral Neck Fractures ◽  
Cannulated Screws ◽  
Anatomical Reduction ◽  
Aged Patients ◽  
Fracture Displacement ◽  
Appropriate Treatment ◽  
Neck Fracture

Background: In middle-aged patients, treatment of femoral neck fractures is still debated between osteosynthesis and replacement. Describing predictive factors is essential to choose the appropriate treatment for each patient. The aim of this study was to describe risk factors for avascular necrosis (AVN) of the femur head in patients with femoral neck fractures treated with three cannulated screws. Methods: We conducted a retrospective study of 91 patients between January of 2011 and February of 2017. Fractures were classified according to Garden and Pauwels classifications, fracture displacement was measured in millimetres (mm), quality of reduction was classified as anatomical or not anatomical; all post-operative radiographs were classified with Garden Alignment Index (GAI). Demographic data were recorded and analyzed. Results: AVN was found in six cases (6.6%). The Garden Classification ([Formula: see text]), GAI classification ([Formula: see text]), fracture displacement in mm ([Formula: see text]) and anatomical reduction ([Formula: see text]) were significantly associated with AVN. The most important risk factor for AVN was suboptimal reduction in axial view evaluated with GAI ([Formula: see text]). One case of AVN occurred in patients with GAI considered excellent (71.42%); no AVN occurred in patients with anatomical reduction (47.2%). Conclusions: Anatomical reduction in patients with femoral neck fractures treated with cannulated screws is mandatory. The degree of displacement before surgery influences the outcome but post-operative anatomical reduction, especially in the lateral view, is the most important predictive factor for the outcome: decreasing the Lateral Garden Angle (LGA) from 180∘ increases significantly the risk for AVN.

scholarly journals Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture

2016 ◽  
Vol 98 (6) ◽  
pp. 376-379 ◽  
Author(s):  
O Riaz ◽  
R Arshad ◽  
S Nisar ◽  
R Vanker
Keyword(s):  
Femoral Neck ◽  
Serum Albumin ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Fixation Failure ◽  
Non Union ◽  
Preoperative Serum ◽  
Neck Fracture ◽  
Posterior Tilt ◽  
Intracapsular Femoral Neck Fracture

Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%–19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60–101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.

scholarly journals The Probability of and Risk Factors for Femoral Neck Shortening and Internal Fixation Failure After Femoral Neck Fracture Treatment Using Cannulated Screws Combined With a Medial Buttress Plate

2021 ◽  
Author(s):  
Jinglei Xu ◽  
Xue Bai ◽  
Chenyang Xu ◽  
Xianzhong Ma
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Femoral Neck Fracture ◽  
Fracture Site ◽  
Cannulated Screws ◽  
Fixation Failure ◽  
Neck Fracture ◽  
Buttress Plate

Abstract Background: A range of postoperative complications make femoral neck fracture difficult to treat. Femoral neck shortening and internal fixation failure are two most prevalent complications associated with many surgical strategies. This study evaluates the probability of and risk factors for these complications after the treatment of femoral neck fracture using cannulated screws combined with a medial buttress plate.Methods: Data of 70 patients with femoral neck fractures treated using cannulated screws combined with a medial buttress plate in our hospital between March 2016 and March 2019 were retrospectively analyzed, and 40 patients who were followed up for more than 3 months were enrolled in the study. We evaluated the probability of postoperative femoral neck shortening and internal fixation failure and conducted multivariate logistic regression analysis to determine risk factors.Results: All 40 patients had Garden III/IV or Pauwels II/III fractures. Of these patients, 11 had femoral neck shortening greater than 5 mm and 8 had fracture nonunion or screw cutout requiring reoperation. There were no differences in age, sex, fracture site, Pauwels classification, and reduction quality between the shortening and non-shortening groups; however, there were significant differences in screw quality. Similarly, there were no differences in age, sex, Pauwels classification, reduction quality, and screw quality between the fixation failure and non-failure groups, but there were significant differences in fracture site and shortening. According to the multivariate analyses, screw quality was an independent risk factor for femoral neck shortening (odds ratio [OR]: 8.58; 95% confidence interval [CI]: 1.35–50.57; P=0.022), and femoral neck shortening was an independent risk factor for internal fixation failure (OR: 11.82; 95% CI: 1.66–84.36; P=0.014).Conclusions: Femoral neck fracture treatment using cannulated screws combined with a medial buttress plate led to a femoral neck shortening rate lower than that of other internal fixation methods and an internal fixation failure rate lower than or equivalent to that of other internal fixation methods. The quality of cannulated screws is a risk factor for postoperative shortening of the femoral neck, and femoral neck shortening is a risk factor for postoperative internal fixation failure.

scholarly journals Results of postoperative anti-rotation on the intracapsular femoral neck fracture fixed with cannulated screws

2020 ◽  
Author(s):  
bu-fang ren ◽  
quan-ping ma ◽  
xin lv ◽  
yunsheng yin ◽  
yaozhu gao
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Bed Rest ◽  
Femoral Neck Fractures ◽  
Wound Infections ◽  
Cannulated Screws ◽  
Fracture Nonunion ◽  
Neck Fracture ◽  
Intracapsular Femoral Neck Fracture ◽  
Medical University

Abstract Background: To investigate effect of postoperative anti-rotation on the union of intracapsular displaced femoral neck fracture treated with three cannulated screws. Methods: A retrospective analysis was performed on all the intracapsular femoral neck fractures treated in the department of orthopedics of the second Hospital of Shanxi Medical University from July 2015 to December 2018. Fractures of femoral neck were reduced and fixed with three cannulated screws. The patients who wore anti-rotation shoes in the affected side were kept at bed rest for 10-12 weeks after surgery. The results were analyzed.Results: A total of 135 patients were included in the analysis. Six patients (4.4%) were not united. There were 12 cases of avascular necrosis (9.3%). No wound infections, screw breakages was found.Conclusion: Anti-rotation after surgery can significantly reduce the rate of femoral neck fracture nonunion, but not significantly improve the femoral head necrosis

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

Stability of femoral neck fracture fixation: A finite element analysis

2019 ◽  
Vol 233 (9) ◽  
pp. 892-900 ◽  
Author(s):  
Shabnam Samsami ◽  
Peter Augat ◽  
Gholamreza Rouhi
Keyword(s):  
Finite Element ◽  
Femoral Neck ◽  
Fracture Fixation ◽  
Locking Plate ◽  
Femoral Neck Fractures ◽  
Dynamic Hip Screw ◽  
Cannulated Screws ◽  
Fixation Methods ◽  
Neck Fracture ◽  
Hip Screw

Femoral neck fractures represent a relatively uncommon injury in the non-elderly population often resulting from high-energy trauma. Clinical outcome in these patients can be improved by optimizing surgical procedures and selecting appropriate fixation methods. The aim of this study was to develop a numerical fracture model to investigate the influence of critical mechanical factors on the stability of fixation methods for femoral neck fractures. The mechanical stability of fracture fixation was assessed through employing finite element models and simulating progressive consolidation of the fracture for a vertical femoral neck fracture (i.e. Pauwels type III in which the angle between the fracture line and the horizontal plane is greater than 70°). Mechanical performance was compared among three different fixation methods (cannulated screws, dynamic hip screw with de-rotational screw, and proximal femoral locking plate). Axial femoral head displacement varied from 2.3 mm for cannulated screws to 1.12 mm for proximal femoral locking plate, although dynamic hip screw with de-rotational screw indicated a value of 0.94 mm. Considering a consolidated fracture and full weight-bearing load case, average displacements of fracture fragments were obtained of about 1.5, 3 and 70 µm for dynamic hip screw with de-rotational screw, proximal femoral locking plate and cannulated screws methods, respectively. In terms of interfragmentary movements at the fracture site, outcomes of this study demonstrated that, in agreement with our previous experimental research, the dynamic hip screw with de-rotational screw implant is a more effective choice than cannulated screws and proximal femoral locking plate techniques for vertical femoral neck fractures in young patients. Thus, one may conclude that the use of dynamic hip screw with de-rotational screw, particularly during the early stages of bone healing, could provide suitable mechanical environments that facilitate direct bone formation and shorter healing times.

scholarly journals Comparison of Early Clinical Results of Femoral Neck System and Cannulated Screws in the Treatment of Unstable Femoral Neck Fractures

2020 ◽  
Author(s):  
Xiaoqiang Zhou ◽  
Zhiqiang Li ◽  
Renjie Xu ◽  
Yuanshi She ◽  
Xiangxin Zhang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Blood Loss ◽  
Femoral Neck Fracture ◽  
Complication Rate ◽  
Operation Time ◽  
Femoral Neck Fractures ◽  
Cannulated Screws ◽  
Intraoperative Blood Loss ◽  
Neck Fracture

Abstract Objective: To compare the early clinical effects of femoral neck system and three cannulated screws in the treatment of patients with unstable femoral neck fractures.Methods: A retrospective analysis was conducted on 81 patients who received FNS or cannulated screws internal fixation for Pauwels Type-3 femoral neck fracture in our hospital from January 2019 to December 2019. A pair-matched clinical research was performed. People who received FNS were test group and people received cannulated screws were control group. Matching requirements were as follows： the same gender, the similar age and the similar BMI. A total of 30 pairs were successfully matched, with an average age of 53.84 years old. The operation time, intraoperative blood loss, hospital stay, hospitalization cost, postoperative VAS score, time walking without crutches, Harris score, femoral head necrosis rate and complication rate were compared between the two groups.Results: Postoperative re-examination of radiographs showed satisfactory reduction in all patients, and all the patients were followed up for 10-22 months. Patients in the FNS group had lower postoperative VAS scores, earlier time to walk without crutches, higher Harris scores at the last follow-up and lower complication rate (P<0.05). However, intraoperative blood loss and hospitalization costs in the FNS group were more（P<0.05）. There was no statistically significant difference in operation time, hospital stay and femoral head necrosis rate between two group (P>0.05).Conclusion: For patients who were unstable femoral neck fracture, FNS has better clinical efficacy than cannulated screws, though FNS is more expensive. The excellent biomechanical performance and clinical efficacy of FNS make it a new choice for the treatment of unstable femoral neck fracture.Fund program: Key medical research project of Jiangsu Health Committee（K2019010）

scholarly journals Results of the application of a new method of internal fixation of femoral neck fractures - self-tapping antirotation cannulated screws (SAF)

2013 ◽  
Vol 60 (2) ◽  
pp. 71-79
Author(s):  
Igor Kostic ◽  
Milan Mitkovic ◽  
Milorad Mitkovic
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Femoral Neck Fracture ◽  
Functional Recovery ◽  
Femoral Neck Fractures ◽  
New Method ◽  
Cannulated Screws ◽  
Neck Fracture

Introduction: Femoral neck fractures are one of the most common fractures primarily the elderly, coupled with a high degree of morbidity and mortality. The treatment is applied a number of methods of internal fixation (multiple cannulated screws available, DHS system, cefalomedullary). At the Department of Orthopedics and Traumatology of Nis developed a new method of fixation of femoral neck fracture, which allows stable fixation of dislocated and nondislocated femoral neck fracture. Self-tapping antirotation fixation (SAF) using two cannulated screws to initial compression fractures intraoperative and postoperative dynamic linear compression of the fracture with early full support to the patient. Matherial and methods: In the period between 2008 to 2012, 53 patients treated for femoral neck fracture in the Clinic for orthopedic and traumatology, Clinical center in Nis, Serbia, by SAF (the self-tapping cannulated screws antirotation; ORTOKON doo Nis). All patients were followed up after surgery in a minimum period of 13 weeks (13-106 weeks). The outcome was evaluated on the basis of clinical and radiological signs of fracture healing and the Harris hip score of functional recovery of the patient. Results: Of the total number of patients (53) treated with this method of fixation, 31 of them were females and 22 males, mean age 52.7 years (28-75 years). The average time of surgery was 36.4 minutes (19-70 minutes). During the postoperative follow-up of all patients (53) operated by this method, six patients were lost in the further postoperative monitoring, so that 47 patients remained for final evaluation. The total incidence of nonunion of femoral neck fracture after surgery this method was 6.4% (three patients). Shortening of the femoral neck after fixation by this method was recorded in 27 cases, and what amounted to an average of 2.8 mm (1, 2 mm in nondislocated to 4.55 with dislocated fracture) and did not affect the functional outcome. During radiographic follow-up was not detected fracture implants. Conclusion: Self-tapping screws cannulated antirotacioni (SAF method) represent a reliable method of fixation of dislocated and nondislocated femoral neck fracture. The main prerequisite for the proper healing of femoral neck fractures with this method is that anatomical fracture reduction is achieved by a closed or open method. This way of fixation allows the early full weight bearing patient operated limb and faster postoperative functional recovery of the fracture healing in optimal time.

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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