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While the medial buttress plate is a recognized solution, it requires extensive deep dissection. This study aims to compare the biomechanical performance of various screw configurations combined with either a medial buttress or anteromedial support plate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Twenty-five third-generation synthetic femurs were used to create a standardized 70-degree (Pauwels III) fracture model. Specimens were divided into five groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095): (A) Inverted triangle (IT) screws with a Pauwels screw, (B) Inverted triangle (IT) with medial buttress plate (MBP), (C) Inverted triangle with anteromedial support plate (ASP), (D) L-configuration with medial buttress plate (MBP), and (E) L-configuration with anteromedial support plate (ASP). Axial loading was applied at 2\u00a0mm\/min until construct failure, defined objectively by the real-time force-distance curve.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Although no statistically significant difference was found between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.102), a large effect size was observed (\u03b7\u00b2 = 0.309). Group C (IT\u2009+\u2009ASP) demonstrated the highest mean failure load (1695\u2009\u00b1\u2009494.6\u00a0N). Conversely, Group E (L-configuration\u2009+\u2009ASP) exhibited the lowest stability (977.2\u2009\u00b1\u2009195.4\u00a0N) with a remarkably narrow standard deviation. The majority of failures occurred as transverse subtrochanteric fractures distal to the implants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of an inverted triangle screw arrangement with an anteromedial support plate demonstrated comparable biomechanical stability to the medial buttress plate, while offering a potentially safer surgical corridor. Conversely, pairing L-shaped screw configurations with anteromedial support plates resulted in the lowest mean ultimate load-to-failure among the tested constructs, likely due to potential stress riser effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06352-x","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T06:21:14Z","timestamp":1780726874000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical comparison of inverted triangle and L-shaped screw configurations with medial buttress and anteromedial support plate in Pauwels type III femoral neck fractures"],"prefix":"10.1007","volume":"146","author":[{"given":"Murat","family":"Erem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utku","family":"Demirta\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sava\u015f","family":"Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E\u015fref","family":"Sel\u00e7uk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cem","family":"\u00c7opuro\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"issue":"Suppl 1","key":"6352_CR1","doi-asserted-by":"publisher","first-page":"S20","DOI":"10.1097\/bot.0000000000001367","volume":"33","author":"M Duffin","year":"2019","unstructured":"Duffin M, Pilson HT (2019) Technologies for young femoral neck fracture fixation. 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