Vertical Shear Fractures of the Femoral Neck A Biomechanical Study

Contemporary management of femoral neck fractures: the young and the old

“…Typically, three cancellous lag screws oriented along the femoral neck axis and parallel to each other are placed in an inverted triangle. This configuration is biomechanically superior to any other orientation and decreases the risk of subtrochanteric fracture [36][37][38][39][40][41][42][43]. As demonstrated by Lindequist et al [44••] and other previous authors, the first screw should be placed within 3 mm of the cortical calcar femorale to allow a three-point buttressing effect (with fixation in the dense subcortical femoral head, the calcar, and the lateral femoral cortex of entry) [45].…”

“…Pooling from over 1900 patients, Bhandari found statistically insignificant higher rates of infection, blood loss, and a trend towards a higher four month mortality in those treated with arthroplasty; those treated with internal fixation had a four fold higher risk of subsequent surgery and conversion to hip replacement [60••]. A meta-analysis of 2289 patients by Rogmark et al [38] reviewed 14 studies and showed that primary arthroplasty leads to significantly fewer major method-related hip complications (deep infection, early redisplacement, nonunion, avascular necrosis) and reoperations, compared to internal fixation. In all studies comparing methods of internal fixation, regardless of the type of fixation, the failure rate was 21-57 % and reoperations were performed in 14-53 % of all the cases.…”

The le fort system revisited: trauma velocity predicts the path of le fort i fractures through the lateral buttress

“…The study of long bones provides an example for which strength and failure points in response to compressive, torsional, tensile and shear forces have been studied extensively (9)(10)(11)(12). This detailed understanding has enabled the development of model systems for the femur that accurately classify these fractures and improve reconstruction techniques (11).…”

Primary management of fracture of femoral neck in young adults using Valgus Osteotomy and fixation with Dynamic hip screw and plate: A case series

“…and Rinaldi reports 81 -89 % excellent to good results. 27,28 Several biomechanical studies 29,30 have evaluated different implants for managing Pauwels' Type III femoral neck fractures. Baitner et al 29 compared multiple screws to the DHS for treatment of Pauwels' Type III femoral neck fracture.…”

“…27,28 Several biomechanical studies 29,30 have evaluated different implants for managing Pauwels' Type III femoral neck fractures. Baitner et al 29 compared multiple screws to the DHS for treatment of Pauwels' Type III femoral neck fracture. They found that the DHS had less inferior femoral head displacement, less shearing displacement and a greater load to failure when compared to the three cannulated cancellous screws.…”