{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:50:57Z","timestamp":1790776257109,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018525","name":"Key Research and Development Program of Sichuan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018525","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite the biomechanical advantages of the Femoral Neck System (FNS), improvements in postoperative complication rates have not been significant. This study evaluated the effects of different FNS positions on the biomechanical stability of Pauwels type III femoral neck fractures (FNFs) using finite element analysis (FEA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pauwels type III FNF models fixed with different FNS positions were constructed using various bolt lengths, bolt positions, and axis\u2013bolt angles. Biomechanical parameters, including stiffness, maximum implant von Mises stress (MIVS), maximum interfragmentary shear stress (MISS), and maximum interfragmentary gap (MIG), were analyzed by simulating early postoperative weight-bearing. Entropy scoring was used to rank the performance of different fixation positions to determine the optimal FNS implantation position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with that of the standard model, the biomechanical stability changed when FNS positioning was altered. Among all the evaluated parameters, MIG had the highest weight (60.04%). In the lateral view, fracture fixation was most stable when the bolt was rotated 5\u00b0 anteriorly relative to the femoral neck axis (composite score = 0.87). However, stability was poorer when the bolt was rotated 9\u00b0 inward relative to the femoral neck axis (composite score = 0.13).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The MIG is an important biomechanical parameter for assessing the stability of different FNS positions when treating FNFs. Shortening the distance between the bolt and the subchondral bone, upward movement, external rotation, and anterior rotation of the bolt can help improve the stability of the FNS in the treatment of Pauwels III FNFs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fbioe.2025.1493555","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:43:20Z","timestamp":1740379400000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Computational evaluation of the biomechanical effects of position changes in the femoral neck system on Pauwels type III femoral neck fractures: an in silico study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenghang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongwei","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1016\/j.injury.2018.01.005","article-title":"Trochanteric fracture-implant motion during healing - a radiostereometry (RSA) study","volume":"49","author":"Bojan","year":"2018","journal-title":"Injury"},{"key":"B2","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jhevol.2013.12.013","article-title":"Functional integrative analysis of the human hip joint: the three-dimensional orientation of the acetabulum and its relation with the orientation of the femoral neck","volume":"69","author":"Bonneau","year":"2014","journal-title":"J. Hum. Evol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.1038\/s41598-023-29513-z","article-title":"Hip joint function and reconstruction of the anterior femoral offset in patients with short stem vs. conventional THA","volume":"13","author":"Budde","year":"2023","journal-title":"Sci. Rep."},{"key":"B4","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1186\/s12891-023-06631-3","article-title":"Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis","volume":"24","author":"Cha","year":"2023","journal-title":"BMC Musculoskelet. Disord."},{"key":"B5","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1186\/s12891-021-04497-x","article-title":"Improved control over implant anchorage under the use of the femoral neck system for fixation of femoral neck fractures: a technical note","volume":"22","author":"Cha","year":"2021","journal-title":"BMC Musculoskelet. Disord."},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1007\/s11914-019-00501-5","article-title":"Mechanisms underlying normal fracture healing and risk factors for delayed healing","volume":"17","author":"Cheng","year":"2019","journal-title":"Curr. Osteoporos. Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.2106\/jbjs.k.00357","article-title":"Reliability of predictors for screw cutout in intertrochanteric hip fractures","volume":"94","author":"De Bruijn","year":"2012","journal-title":"J. Bone Jt. Surg. Am."},{"key":"B8","doi-asserted-by":"publisher","first-page":"276","DOI":"10.2106\/jbjs.o.00684","article-title":"Motion predicts clinical callus formation: construct-specific finite element analysis of supracondylar femoral fractures","volume":"98","author":"Elkins","year":"2016","journal-title":"J. Bone Jt. Surg. Am."},{"key":"B9","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1302\/0301-620x.98b7.36061","article-title":"A unified theory of bone healing and nonunion: BHN theory","author":"Elliott","year":"2016","journal-title":"Bone Jt. J."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.1016\/j.injury.2021.05.043","article-title":"How to choose the suitable FNS specification in young patients with femoral neck fracture: a finite element analysis","volume":"52","author":"Fan","year":"2021","journal-title":"Injury"},{"key":"B11","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1002\/jor.22266","article-title":"The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: a subject-specific finite element study","volume":"31","author":"Goffin","year":"2013","journal-title":"J. Orthop. Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1116976","DOI":"10.3389\/fbioe.2023.1116976","article-title":"Biomechanical evaluation of two modified intramedullary fixation system for treating unstable femoral neck fractures: a finite element analysis","volume":"11","author":"Huang","year":"","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12938-023-01083-1","article-title":"Comparison of femoral neck system and three cannulated cancellous screws in the treatment of vertical femoral neck fractures: clinical observation and finite element analysis","volume":"22","author":"Huang","year":"","journal-title":"Biomed. Eng. Online"},{"key":"B14","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1186\/s12891-023-06579-4","article-title":"Trajectory of bolt and length of plate in femoral neck system determine the stability of femur neck fracture and risk of subsequent subtrochanteric fracture: a finite element analysis","volume":"24","author":"Jung","year":"2023","journal-title":"BMC Musculoskelet. Disord."},{"key":"B15","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1302\/2046-3758.112.bjr-2021-0282.r1","article-title":"Mechanical effects of surgical variations in the femoral neck system on Pauwels type III femoral neck fracture: a finite element analysis","volume":"11","author":"Jung","year":"2022","journal-title":"Bone Jt. Res."},{"key":"B16","doi-asserted-by":"publisher","first-page":"103812","DOI":"10.1016\/j.medengphy.2022.103812","article-title":"Biomechanical analysis of three popular tibial designs for TAR with different implant-bone interfacial conditions and bone qualities: a finite element study","volume":"104","author":"Jyoti","year":"2022","journal-title":"Med. Eng. Phys."},{"key":"B17","doi-asserted-by":"publisher","first-page":"78","DOI":"10.13107\/jocr.2024.v14.i03.4294","article-title":"Limitations and complications in treating femoral neck fractures with the femoral neck system: a case report","volume":"14","author":"Kale","year":"2024","journal-title":"J. Orthop. Case Rep."},{"key":"B18","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1016\/s0020-1383(16)47005-1","article-title":"When is the stability of a fracture fixation limited by osteoporotic bone?","volume":"47","author":"Konstantinidis","year":"2016","journal-title":"Injury"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1007\/s00068-023-02253-5","article-title":"Choose the appropriate implantation position of the Femoral Neck System in the femoral neck: a finite-element analysis","volume":"49","author":"Kuang","year":"2023","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"B20","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s11914-021-00690-y","article-title":"Finite element analysis of fracture fixation","volume":"19","author":"Lewis","year":"2021","journal-title":"Curr. Osteoporos. Rep."},{"key":"B21","doi-asserted-by":"publisher","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 Jt. Surg. Am."},{"key":"B22","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.gendis.2019.04.006","article-title":"Biomechanical analysis of the computer-assisted internal fixation of a femoral neck fracture","volume":"7","author":"Lu","year":"2020","journal-title":"Genes Dis."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1186\/s12891-022-06003-3","article-title":"Finite element comparative analysis of three different internal fixation methods in the treatment of Pauwels type III femoral neck fractures","volume":"23","author":"Ma","year":"2022","journal-title":"BMC Musculoskelet. Disord."},{"key":"B24","doi-asserted-by":"publisher","first-page":"7915","DOI":"10.1038\/s41598-022-11914-1","article-title":"Biomechanical comparison of the femoral neck system and the dynamic hip screw in basicervical femoral neck fractures","volume":"12","author":"Moon","year":"2022","journal-title":"Sci. Rep."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1186\/s12891-022-06016-y","article-title":"Mechanical effects of sagittal variations on Pauwels type III femoral neck fractures treated with Femoral Neck System(FNS)","volume":"23","author":"Nan","year":"2022","journal-title":"BMC Musculoskelet. Disord."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1007\/s10237-015-0741-6","article-title":"Effect of boundary conditions on yield properties of human femoral trabecular bone","volume":"15","author":"Panyasantisuk","year":"2016","journal-title":"Biomech. Model Mechanobiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e302","DOI":"10.5435\/jaaos-d-23-00720","article-title":"High-energy femoral neck fractures in young patients","volume":"32","author":"Rajfer","year":"2024","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"B28","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jor.2022.05.007","article-title":"Does the femoral neck system provide better outcomes compared to cannulated screws fixation for the management of femoral neck fracture in young adults? A systematic review of literature and meta-analysis","volume":"32","author":"Rajnish","year":"2022","journal-title":"J. Orthop."},{"key":"B29","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1007\/s40846-015-0085-9","article-title":"Comparison of three fixation methods for femoral neck fracture in young adults: experimental and numerical investigations","volume":"35","author":"Samsami","year":"2015","journal-title":"J. Med. Biol. Eng."},{"key":"B30","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1007\/s11914-021-00714-7","article-title":"Finite element assessment of bone fragility from clinical images","volume":"19","author":"Schileo","year":"2021","journal-title":"Curr. Osteoporos. Rep."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2069","DOI":"10.1007\/s00264-015-2881-9","article-title":"A comparative study between multiple cannulated screws and dynamic hip screw for fixation of femoral neck fracture in adults","volume":"39","author":"Siavashi","year":"2015","journal-title":"Int. Orthop."},{"key":"B32","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.injury.2014.11.020","article-title":"Young femoral neck fractures: are we measuring outcomes that matter?","volume":"46","author":"Sprague","year":"2015","journal-title":"Injury"},{"key":"B33","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1097\/bot.0000000000000739","article-title":"Biomechanical evaluation of the femoral neck system in unstable pauwels III femoral neck fractures: a comparison with the dynamic hip screw and cannulated screws","volume":"31","author":"Stoffel","year":"2017","journal-title":"J. Orthop. Trauma"},{"key":"B34","doi-asserted-by":"publisher","first-page":"106409","DOI":"10.1016\/j.cmpb.2021.106409","article-title":"Biomechanical study of two alternative methods for the treatment of vertical femoral neck fractures - a finite element analysis","volume":"211","author":"Xia","year":"2021","journal-title":"Comput. Methods Programs Biomed."},{"key":"B35","doi-asserted-by":"publisher","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":"95","author":"Yang","year":"2013","journal-title":"J. Bone Jt. Surg. Am."},{"key":"B36","doi-asserted-by":"publisher","first-page":"108036","DOI":"10.1016\/j.cmpb.2024.108036","article-title":"Single-plane osteotomy model is inaccurate for evaluating the optimal strategy in treating vertical femoral neck fractures: a finite element analysis","volume":"245","author":"Zhan","year":"2024","journal-title":"Comput. Methods Programs Biomed."},{"key":"B37","doi-asserted-by":"publisher","first-page":"106060","DOI":"10.1016\/j.clinbiomech.2023.106060","article-title":"Femoral neck system and cannulated compression screws in the treatment of non-anatomical reduction Pauwels type-III femoral neck fractures: a finite element analysis","volume":"108","author":"Zhong","year":"2023","journal-title":"Clin. Biomech. (Bristol, Avon)"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1111\/os.13098","article-title":"Comparison of early clinical results for femoral neck system and cannulated screws in the treatment of unstable femoral neck fractures","volume":"13","author":"Zhou","year":"2021","journal-title":"Orthop. Surg."}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1493555\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:43:29Z","timestamp":1740379409000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1493555\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":38,"alternative-id":["10.3389\/fbioe.2025.1493555"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2025.1493555","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]},"article-number":"1493555"}}