{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:13:37Z","timestamp":1777464817155,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BME"],"published-print":{"date-parts":[[2022,7,15]]},"abstract":"<jats:p>BACKGROUND: Femoral neck fracture is an unsolved challenge in orthopedics. The complication rate in particular is high. There remains a lack of consensus on the optimal choice of internal fixation for unstable femoral neck fracture. OBJECTIVE: The study aimed to develop a new headless compression supporting screw (HCSS) for the treatment of unstable foemoral neck fracture. METHODS: We designed a new HCSS and used a femoral neck fracture (Pauwels III fracture) model (left, fourth-generation composite, Sawbones) and three-dimensional finite element analysis to compare the biomechanical performance of HCSSs with that of cannulated compression screws (CCSs) for treatment of unstable femoral neck fracture. RESULTS: Maximum displacement, peak von Mises stress, peak strain, and rotation for the HCSS were smaller than those for the CCS. The stress was more widely distributed for the HCSS, whereas the stress was concentrated for the CCS. CONCLUSIONS: The HCSS resulted in better biomechanical stability than that from the CCS. For Pauwels III fractures the HCSS exhibits better resistance to shear forces and better support, providing a new clinical treatment.<\/jats:p>","DOI":"10.3233\/bme-211313","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T10:37:10Z","timestamp":1644575830000},"page":"279-292","source":"Crossref","is-referenced-by-count":2,"title":["Finite element analysis of new headless compression supporting screw for the treatment of unstable femoral neck fracture"],"prefix":"10.1177","volume":"33","author":[{"given":"Yang","family":"Xue","sequence":"first","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiong-Fei","family":"Wang","sequence":"additional","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu-Long","family":"Zhao","sequence":"additional","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da-Cheng","family":"Han","sequence":"additional","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An-Hua","family":"Long","sequence":"additional","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Wang","sequence":"additional","affiliation":[{"name":", Nantong University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Kui","family":"Zhang","sequence":"additional","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-Fei","family":"Wang","sequence":"additional","affiliation":[{"name":", Beijing LuHe Hospital Affiliated to Capital Medical University, , China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/BME-211313_ref1","doi-asserted-by":"crossref","first-page":"C1","DOI":"10.1016\/S0020-1383(02)00324-8","article-title":"Epidemiology of femoral neck fractures","volume":"33","author":"Thorngren","year":"2002","journal-title":"Injury"},{"issue":"8","key":"10.3233\/BME-211313_ref2","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.2106\/JBJS.G.01353","article-title":"Results of internal fixation of Pauwels type-3 vertical femoral neck fractures","volume":"90","author":"Liporace","year":"2008","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"10.3233\/BME-211313_ref3","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2106\/JBJS.K.01081","article-title":"Risk factors for nonunion in patients with intracapsular femoral neck fractures treated with three cannulated screws placed in either a triangle or an inverted triangle configuration","volume":"95a","author":"Yang","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"10.3233\/BME-211313_ref4","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/00005131-200106000-00009","article-title":"Pauwels\u2019 classification of femoral neck fractures: Correct interpretation of the original","volume":"15","author":"Bartonicek","year":"2001","journal-title":"J Orthop Trauma"},{"issue":"3","key":"10.3233\/BME-211313_ref5","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.injury.2014.10.010","article-title":"Complications following young femoral neck fractures","volume":"46","author":"Slobogean","year":"2015","journal-title":"Injury"},{"issue":"1","key":"10.3233\/BME-211313_ref6","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s13018-018-0827-9","article-title":"The clinical application of a novel method of internal fixation for femoral neck fractures-dynamic locking compression system","volume":"13","author":"Xiao","year":"2018","journal-title":"J Orthop Surg Res"},{"issue":"7","key":"10.3233\/BME-211313_ref7","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1302\/0301-620X.82B7.0820937","article-title":"The management of intracapsular fractures of the proximal femur","volume":"82","author":"Parker","year":"2000","journal-title":"J Bone Joint Surg Br"},{"issue":"3","key":"10.3233\/BME-211313_ref8","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/BOT.0000000000000205","article-title":"Biomechanical analysis of augmented plate fixation for the treatment of vertical shear femoral neck fractures","volume":"29","author":"Kunapuli","year":"2015","journal-title":"J Orthop Trauma"},{"issue":"12","key":"10.3233\/BME-211313_ref9","doi-asserted-by":"crossref","first-page":"e1117","DOI":"10.3928\/01477447-20141124-60","article-title":"Analysis of risk factors for femoral head necrosis after internal fixation in femoral neck fractures","volume":"37","author":"Wang","year":"2014","journal-title":"Orthopedics"},{"issue":"15","key":"10.3233\/BME-211313_ref10","doi-asserted-by":"crossref","first-page":"3282","DOI":"10.1016\/j.jbiomech.2008.08.013","article-title":"Structural properties of fourth-generation composite femurs and tibias","volume":"41","author":"Heiner","year":"2008","journal-title":"J Biomech"},{"issue":"3","key":"10.3233\/BME-211313_ref11","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s10439-009-9887-7","article-title":"Mechanical evaluation of large-size fourth-generation composite femur and tibia models","volume":"38","author":"Gardner","year":"2010","journal-title":"Ann Biomed Eng"},{"issue":"3","key":"10.3233\/BME-211313_ref12","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.injury.2018.11.020","article-title":"Treatment of femoral neck fractures in patients 45\u201364 years of age","volume":"50","author":"Johnson","year":"2019","journal-title":"Injury"},{"issue":"6","key":"10.3233\/BME-211313_ref13","first-page":"1537","article-title":"A biomechanical comparison of two triple-screw methods for femoral neck fracture fixation in a synthetic bone model","volume":"69","author":"Zdero","year":"2010","journal-title":"J Trauma"},{"issue":"2","key":"10.3233\/BME-211313_ref14","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/S0020-1383(03)00059-7","article-title":"Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures: A biomechanical study","volume":"35","author":"Selvan","year":"2004","journal-title":"Injury"},{"issue":"9","key":"10.3233\/BME-211313_ref15","first-page":"405","article-title":"Clinical and economic impact of using generic 7.3-mm cannulated screws at a level II trauma center","volume":"43","author":"Althausen","year":"2014","journal-title":"J Orthop"},{"issue":"2","key":"10.3233\/BME-211313_ref16","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5405\/jmbe.826","article-title":"Fatigue testing of a new locking plate for hip fractures","volume":"32","author":"Hunt","year":"2012","journal-title":"J Med Biol Eng"},{"issue":"11","key":"10.3233\/BME-211313_ref17","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/j.injury.2011.07.004","article-title":"Biomechanical evaluation of the expansive cannulated screw for fixation of femoral neck fractures","volume":"42","author":"Zhang","year":"2011","journal-title":"Injury"},{"issue":"11","key":"10.3233\/BME-211313_ref18","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1302\/0301-620X.87B11.17089","article-title":"The complications of displaced intracapsular fractures of the hip","volume":"87","author":"Todkar","year":"2005","journal-title":"J Bone Joint Surg Br"},{"issue":"3","key":"10.3233\/BME-211313_ref19","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.injury.2014.12.031","article-title":"Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly","volume":"46","author":"Panteli","year":"2015","journal-title":"Injury"},{"issue":"1\u20132","key":"10.3233\/BME-211313_ref20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/0021-9290(78)90045-3","article-title":"A biomechanical investigation of the human hip","volume":"11","author":"Crowninshield","year":"1978","journal-title":"J Biomech"},{"issue":"10","key":"10.3233\/BME-211313_ref21","doi-asserted-by":"crossref","first-page":"C41","DOI":"10.1016\/S0020-1383(02)00330-3","article-title":"Intracapsular femoral neck fractures: The importance of early reduction and stable osteosynthesis","volume":"33","author":"Szita","year":"2002","journal-title":"Injury"},{"issue":"2","key":"10.3233\/BME-211313_ref22","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3944\/AOTT.2014.3159","article-title":"Biomechanical comparison of antirotator compression hip screw and cannulated screw fixations in the femoral neck fractures","volume":"48","author":"Saglam","year":"2014","journal-title":"Acta Orthop Traumatol Turc"},{"issue":"9","key":"10.3233\/BME-211313_ref23","doi-asserted-by":"crossref","first-page":"e293","DOI":"10.1097\/BOT.0000000000000351","article-title":"Incidence, magnitude, and predictors of shortening in young femoral neck fractures","volume":"29","author":"Stockton","year":"2015","journal-title":"J Orthop Trauma"},{"issue":"8","key":"10.3233\/BME-211313_ref24","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1016\/j.injury.2017.06.013","article-title":"Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC)","volume":"48","author":"Slobogean","year":"2017","journal-title":"Injury"},{"issue":"11","key":"10.3233\/BME-211313_ref25","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1302\/0301-620X.90B11.20582","article-title":"The effect of shortening and varus collapse of the femoral neck on function after fixation of intracapsular fracture of the hip: a multi-centre cohort study","volume":"90","author":"Zlowodzki","year":"2008","journal-title":"J Bone Joint Surg Br"},{"issue":"8","key":"10.3233\/BME-211313_ref26","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/BOT.0b013e31814b822e","article-title":"Vertically oriented femoral neck fractures: Mechanical analysis of four fixation techniques","volume":"21","author":"Aminian","year":"2007","journal-title":"J Orthop Trauma"},{"issue":"1","key":"10.3233\/BME-211313_ref27","first-page":"26","article-title":"Efficacy comparison between dynamic hip screw combined with anti-rotation screw and cannulated screw in treating femoral neck fractures","volume":"25","author":"Chen","year":"2011","journal-title":"Chinese J Reparative and Reconstructive Surg"},{"key":"10.3233\/BME-211313_ref28","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1007\/s00132-017-3473-8","article-title":"Multiple cannulated screws vs. dynamic hip screws for femoral neck fractures","volume":"46","author":"Lei","year":"2017","journal-title":"Der Orthopade"},{"issue":"2","key":"10.3233\/BME-211313_ref29","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.clinbiomech.2013.11.008","article-title":"The effect of interlocking parallel screws in subcapital femoral-neck fracture fixation: A cadaver study","volume":"29","author":"Basso","year":"2014","journal-title":"Clin Biomech"},{"issue":"5","key":"10.3233\/BME-211313_ref30","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.clinbiomech.2014.03.006","article-title":"Locking plates and their effects on healing conditions and stress distribution: A femoral neck fracture study in cadavers","volume":"29","author":"Basso","year":"2014","journal-title":"Clin Biomech"},{"issue":"10","key":"10.3233\/BME-211313_ref31","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.injury.2016.07.030","article-title":"Augmentation by cerclage wire improves fixation of vertical shear femoral neck fractures-A biomechanical analysis","volume":"47","author":"Kuan","year":"2016","journal-title":"Injury"},{"issue":"1","key":"10.3233\/BME-211313_ref32","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13018-019-1097-x","article-title":"Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis","volume":"14","author":"Li","year":"2019","journal-title":"J Orthop Surg Res"}],"container-title":["Bio-Medical Materials and Engineering"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/BME-211313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:24:14Z","timestamp":1777382654000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/BME-211313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,15]]},"references-count":32,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3233\/bme-211313","relation":{},"ISSN":["0959-2989","1878-3619"],"issn-type":[{"value":"0959-2989","type":"print"},{"value":"1878-3619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,15]]}}}