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Background <p>Pauwels III femoral neck fractures are challenging for orthopedic surgeons due to the high shear force and frequent complications. The best treatment approach for this type of fracture remains an undetermined issue. The Femoral Neck Antirotation and Support System (FNAS) was designed to withstand increased shear and torsional forces while minimizing implant cut-out. This study aims to compare the biomechanical outcomes of the FNAS with the Femoral Neck System (FNS) and three cannulated screws (3CS) in the treatment of Pauwels III femoral neck fractures.</p> Methods <p>A finite element model of 70° Pauwels III femoral neck fracture was established. Three different fixation models were constructed: FNAS model, FNS model, and 3CS model. Each model was subjected to a 2100 N load and the stress distribution and displacement of each model were recorded.</p> Results <p>Under 2100 N loading, the peak stress at the fracture end was 25.844&#xa0;MPa for the FNAS model and 27.516&#xa0;MPa for the FNS model, respectively, while the 3CS model exhibited a significantly higher peak stress of 139.14&#xa0;MPa. The maximum femoral displacement was 4.8764&#xa0;mm for the FNAS model, 4.8423&#xa0;mm for the FNS model, and 5.0079&#xa0;mm for the 3CS model, indicating greater stiffness and stability in the FNAS and FNS models. The maximum displacement of internal fixation observed was 4.7541&#xa0;mm for the FNAS model, 4.7359&#xa0;mm for the FNS model, and 4.9265&#xa0;mm for the 3CS model. Internally, the peak stress in the FNS model was 496.26&#xa0;MPa, significantly higher than 338.94&#xa0;MPa in the FNAS model and 229.85&#xa0;MPa in the 3CS model.</p> Conclusion <p>Within the specific context and assumptions of this static finite element model, the FNAS demonstrated biomechanical performance comparable to the FNS in terms of construct stiffness, while exhibiting significantly lower peak implant stress. This suggests that the FNAS may offer a potential advantage in reducing implant failure risk for Pauwels III femoral neck fractures.</p>

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Femoral Neck Antirotation and Support System: A Novel Internal Fixation for Pauwels III Femoral Neck Fractures: A Finite Element Analysis

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Taiyou Wang,
  • Shuquan Guo,
  • Hongyu Lin,
  • Fukang Zhu,
  • Guangjian Wang,
  • Bo Qiao

摘要

Background

Pauwels III femoral neck fractures are challenging for orthopedic surgeons due to the high shear force and frequent complications. The best treatment approach for this type of fracture remains an undetermined issue. The Femoral Neck Antirotation and Support System (FNAS) was designed to withstand increased shear and torsional forces while minimizing implant cut-out. This study aims to compare the biomechanical outcomes of the FNAS with the Femoral Neck System (FNS) and three cannulated screws (3CS) in the treatment of Pauwels III femoral neck fractures.

Methods

A finite element model of 70° Pauwels III femoral neck fracture was established. Three different fixation models were constructed: FNAS model, FNS model, and 3CS model. Each model was subjected to a 2100 N load and the stress distribution and displacement of each model were recorded.

Results

Under 2100 N loading, the peak stress at the fracture end was 25.844 MPa for the FNAS model and 27.516 MPa for the FNS model, respectively, while the 3CS model exhibited a significantly higher peak stress of 139.14 MPa. The maximum femoral displacement was 4.8764 mm for the FNAS model, 4.8423 mm for the FNS model, and 5.0079 mm for the 3CS model, indicating greater stiffness and stability in the FNAS and FNS models. The maximum displacement of internal fixation observed was 4.7541 mm for the FNAS model, 4.7359 mm for the FNS model, and 4.9265 mm for the 3CS model. Internally, the peak stress in the FNS model was 496.26 MPa, significantly higher than 338.94 MPa in the FNAS model and 229.85 MPa in the 3CS model.

Conclusion

Within the specific context and assumptions of this static finite element model, the FNAS demonstrated biomechanical performance comparable to the FNS in terms of construct stiffness, while exhibiting significantly lower peak implant stress. This suggests that the FNAS may offer a potential advantage in reducing implant failure risk for Pauwels III femoral neck fractures.