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<p>Cannulated screws are a cost-effective and commonly utilised option for femoral neck fractures. However, failure rate remains high in Pauwels Type III fracture due to the vertical fracture orientation. Existing methods to reduce the failure rates, such as modifying implants or adding screws, often lead to increased the surgical cost. This study proposed a rotational inverted triangle configuration to enhance the fixation stability without incurring additional cost. Finite element (FE) analysis was conducted to investigate the rotational (10°, 20° and 30°) effects of cannulated screw fixation under varying loads (700 N, 1050 N, 1400 N, 1750 N, and 2100 N) on a Malaysian femur bone model for Pauwels Type III fractures. Rotational configuration significantly reduces stress and deformation, with optimal performance at 20°. These findings therefore demonstrate the advantages of fixation configuration in managing Pauwels Type III fracture compared to the other modifications, as it provides a straightforward and cost-effective option for the patients.</p>

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Optimizing three-cannulated screw fixation for Pauwels Type III femoral neck fractures: angle rotation on a Malaysian adult femur bone model

  • 期刊论文

  • 发表日期：

    2026年7月10日

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  • Darmahssilan Subramaniam,
  • Fauziah Mat,
  • Tan Wei Hong,
  • Muhammad Safwan Bin Muhamad Azmi,
  • Muhammad Hanif Ramlee

摘要

Cannulated screws are a cost-effective and commonly utilised option for femoral neck fractures. However, failure rate remains high in Pauwels Type III fracture due to the vertical fracture orientation. Existing methods to reduce the failure rates, such as modifying implants or adding screws, often lead to increased the surgical cost. This study proposed a rotational inverted triangle configuration to enhance the fixation stability without incurring additional cost. Finite element (FE) analysis was conducted to investigate the rotational (10°, 20° and 30°) effects of cannulated screw fixation under varying loads (700 N, 1050 N, 1400 N, 1750 N, and 2100 N) on a Malaysian femur bone model for Pauwels Type III fractures. Rotational configuration significantly reduces stress and deformation, with optimal performance at 20°. These findings therefore demonstrate the advantages of fixation configuration in managing Pauwels Type III fracture compared to the other modifications, as it provides a straightforward and cost-effective option for the patients.