{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:07:31Z","timestamp":1788793651946,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:00:00Z","timestamp":1603411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003395","name":"Shanghai Municipal Education Commission","doi-asserted-by":"publisher","award":["20172026"],"award-info":[{"award-number":["20172026"]}],"id":[{"id":"10.13039\/501100003395","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004921","name":"Shanghai Jiao Tong University","doi-asserted-by":"publisher","award":["YG2017QN14"],"award-info":[{"award-number":["YG2017QN14"]}],"id":[{"id":"10.13039\/501100004921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Vertical femoral neck fractures in patients younger than 65 years of age often require hip\u2010conserving surgeries. However, traditional fixation strategies using three parallel cannulated screws often fail in such patients due to an unfavorable biomechanical environment. This study compared different cannulated screw fixation techniques in patients via patient\u2010specific finite element analysis with linear tetrahedral (C3D4) elements. Forty vertical femoral neck fracture models were created based on computed tomography images obtained from eight healthy participants. Five different fixation strategies: alpha, buttress, rhomboid, inverted triangle, and triangle were assessed in walking status. Biomechanical parameters including stiffness, interfragmentary motion in two directions (detachment and shearing), compression force, and maximal implant stress were evaluated. The mean relative coefficient of strain distribution between the finite element analysis and experiment was from 0.78 to 0.94. Stiffness was highest (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) in the buttress group (923.1\u2009N\/mm), while interfragmentary motion was lowest (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) in the alpha group. Maximal stress was highest (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) in the buttress group and lowest in the alpha group. Shearing values were significantly lower in the alpha group than in the rhomboid group (<jats:italic>p<\/jats:italic>\u2009=\u2009.004). Moreover, Shearing values were significantly higher (<jats:italic>p<\/jats:italic>\u2009=\u2009.027), while detachment values were significantly lower (<jats:italic>p<\/jats:italic>\u2009=\u2009.027), in the inverted triangle than in the triangle group. Clinical significance: Our results suggest that alpha fixation is the most reliable and biomechanically efficient strategy for young patients with vertical femoral neck fractures. Regular and inverted triangular fixation strategies may be suitable for fractures of different skeletal constructions due to antidetachment\/shearing abilities.<\/jats:p>","DOI":"10.1002\/jor.24881","type":"journal-article","created":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T13:57:46Z","timestamp":1602251866000},"page":"1669-1680","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Biomechanical comparison of five cannulated screw fixation strategies for young vertical femoral neck fractures"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0377-6894","authenticated-orcid":false,"given":"Dajun","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital  Shanghai People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5023-6789","authenticated-orcid":false,"given":"Shi","family":"Zhan","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanical Laboratory, Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital  Shanghai People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanical Laboratory, Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital  Shanghai People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis L.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Chicago Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Ling","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanical Laboratory, Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital  Shanghai People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4940-4044","authenticated-orcid":false,"given":"Hai","family":"Hu","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanical Laboratory, Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital  Shanghai People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9363-5598","authenticated-orcid":false,"given":"Weitao","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital  Shanghai People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"2254","article-title":"Treatment of femoral neck fractures in young adults","volume":"90","author":"Ly TV","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_9_3_1","first-page":"238","article-title":"Hip fractures in adults younger than 50 years of age.\u00a0Epidemiology and results","author":"Robinson C","year":"1995","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-017-5318-5"},{"key":"e_1_2_9_5_1","first-page":"e221\u2013e225","article-title":"Preoperative decision making in the treatment of high\u2010angle \u201cvertical\u201d femoral neck fractures in young adult patients. 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