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Does The Screw Orientation Effect s The Stability Of Femoral Neck Facture?: A Finite Element Analysis
Okan Özkunt1, Kerim Sarıyılmaz1, Turgut Akgül2, Gökhan Polat2, Fatih Dikici1
1Acibadem Atakent University Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey
2Istanbul University Istanbul Medical Faculty, Department of Orthopedics and Traumatology, Istanbul, Turkey
Keywords: femoral neck fractures, cannulated screw, dynamic hip screw, screw position, finite element analysis

Objectives: The incidence of femoral neck fractures in younger-age people increases due to high-energy trauma. To avoid complications, stable internal fixation is essential. The most commonly used implants for vertically oriented femoral neck fractures are the cannulated and dynamic hip screws. In our study, we compared differently oriented cannulated screw configurations and a standard DHS for fixation of femoral neck fracture.

Materials and Methods: A finite element-based collum femoris fracture was created and was fixed using four differently oriented triangular screw configurations and a dynamic hip screw. The loads were applied using a commercially available software package.

Results: Centrally oriented cannulated screw configuration had the most compression and compression stress on the fracture side, and it had the highest stress values on the implant.

Conclusion: We recommend the use of centrally oriented triangular cannulated screws for femoral neck fracture fixation. With this construct, more compression and compression pressure can be obtained, which can result in the early healing of the fracture. However, it must be kept in mind that this construct exerts more stress on the implant, which could be a reason for implant failure.