{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:59:38Z","timestamp":1783335578765,"version":"3.54.6"},"reference-count":26,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to define basicervical and transcervical shear fractures using area classification and to determine the optimal osteosynthesis implants for them. The clinical outcomes of 1042 proximal femur fractures were investigated. A model of the proximal femur of a healthy adult was created from computed tomography images, and basicervical and transcervical shear fractures were established in the model. Osteosynthesis models were created using a short femoral nail with a single lag screw or two lag screws and a long femoral nail with a single lag screw or two lag screws. The minimum principal strains of the fracture surfaces were compared when the maximum loads during walking were applied to these models using finite element analysis software. Basicervical fractures accounted for 0.96% of all proximal femur fractures, 67% of which were treated with osteosynthesis; the failure rate was 0%. Transcervical shear fractures accounted for 9.6% of all proximal femur fractures, 24% of which were treated with osteosynthesis; the failure rate was 13%. Finite element analysis showed that transcervical shear fracture has high instability. To perform osteosynthesis, multiple screw insertions into the femoral head and careful postoperative management are required; joint replacement should be considered to achieve early mobility.<\/jats:p>","DOI":"10.3390\/jcm12227024","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T05:04:56Z","timestamp":1699592696000},"page":"7024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characteristics and Treatment Strategies for Basicervical and Transcervical Shear Fractures of the Femoral Neck"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4939-9545","authenticated-orcid":false,"given":"Hiroaki","family":"Kijima","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita 010-8543, Japan"},{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Yamada","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Kawano","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita 010-8543, Japan"},{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoharu","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Graduate School of Engineering Science, Akita University, 1-1 Tegatagakuen-machi, Akita 010-8502, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuo","family":"Konishi","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Kubota","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tazawa","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Tani","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Kamo","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5164-0065","authenticated-orcid":false,"given":"Masashi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itsuki","family":"Nagahata","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1516-6105","authenticated-orcid":false,"given":"Takanori","family":"Miura","sequence":"additional","affiliation":[{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8075-8319","authenticated-orcid":false,"given":"Shun","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita 010-8543, Japan"},{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohisa","family":"Miyakoshi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita 010-8543, Japan"},{"name":"Akita Hip Research Group, 1-1-1, Hondo, Akita 010-8543, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/BOT.0000000000002557","article-title":"The Association between preoperative international normalized ratio values and postoperative outcomes including Mortality in Geriatric Femoral Neck Fractures Treated with hemiarthroplasty","volume":"37","author":"Uvodich","year":"2023","journal-title":"J. Orthop. Trauma"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2555","DOI":"10.1007\/s00590-023-03474-5","article-title":"Survivability of the Femoral Neck System for the treatment of femoral neck fractures in adults","volume":"33","author":"Stegelmann","year":"2023","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.injury.2022.02.002","article-title":"Stabilisation of AO OTA 31-A unstable proximal femoral fractures: Does the choice of intramedullary nail affect the incidence of post-operative complications? A systematic literature review and meta-analysis","volume":"53","author":"Quartley","year":"2022","journal-title":"Injury"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"744","DOI":"10.3349\/ymj.2022.63.8.744","article-title":"Cephalomedullary Nailing versus Dynamic Hip Screw Fixation in Basicervical Femoral Neck Fracture: A Systematic Review and Meta-Analysis","volume":"63","author":"Yoon","year":"2022","journal-title":"Yonsei Med. J."},{"key":"ref_5","first-page":"e25210","article-title":"Primary hemiarthroplasty for the treatment of basicervical femoral neck fractures","volume":"14","author":"Davis","year":"2022","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","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":"ref_7","doi-asserted-by":"crossref","unstructured":"Huang, B.X., Zhan, S.Z., Yang, M., and Zhang, D.Y. (2023). Biomechanical effects of internal fixation with self-lock compression anti-rotation blade for Pauwels type III femoral neck fractures: A comparative finite element analysis. BMC Musculoskelet. Disord., 24.","DOI":"10.1186\/s12891-023-06386-x"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.3233\/THC-220267","article-title":"Biomechanical comparison of femoral neck system and cannulated screws coupled with medial plate for treating Pauwels III femoral neck fractures","volume":"31","author":"Nan","year":"2023","journal-title":"Technol. Health Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.injury.2022.12.004","article-title":"Structure-mechanical analysis of various fixation constructs for basicervical fractures of the proximal femur and clinical implications; finite element analysis","volume":"54","author":"Kim","year":"2023","journal-title":"Injury"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Liodakis, E., P\u00f6hler, G.H., Sonnow, L., Mommsen, P., Clausen, J.D., Graulich, T., Maslaris, A., Omar, M., St\u00fcbig, T., and Sehmisch, S. (2023). Validation of direct CT measurement of malrotation in femoral neck fractures: A bone model study. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0278850"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"M\u00e9ndez-Ojeda, M.M., Herrera-Rodr\u00edguez, A., \u00c1lvarez-Benito, N., Gonz\u00e1lez-Pacheco, H., Garc\u00eda-Bello, M.A., \u00c1lvarez-de la Cruz, J., and Pais-Brito, J.L. (2023). Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems. J. Clin. Med., 12.","DOI":"10.3390\/jcm12103411"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"250","DOI":"10.5152\/j.aott.2023.23066","article-title":"Comparison of augmentation effects of medial buttress plate versus trochanteric lag screw in the cannulated screw fixation of Pauwels type III femoral neck fractures: A retrospective clinical study","volume":"57","author":"Shen","year":"2023","journal-title":"Acta Orthop. Et Traumatol. Turc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"111018","DOI":"10.1016\/j.injury.2023.111018","article-title":"Biomechanical performance of talon cannulated compression device in Pauwels type III fractures: A comparative study","volume":"54","author":"Uslan","year":"2023","journal-title":"Injury"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4155","DOI":"10.1007\/s00402-022-04686-w","article-title":"Clinical performance of the Femoral Neck System within 1 year in 125 patients with acute femoral neck fractures, a prospective observational case series","volume":"143","author":"Stoffel","year":"2023","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1007\/s11517-023-02771-9","article-title":"Novel screw fixation placement configuration for the treatment of Pauwels type III femoral neck fractures: A finite element analysis","volume":"61","author":"Kodvanj","year":"2023","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/os.13683","article-title":"Gamma Nail Combined with One Cannulated Compression Screw Fixation for Treating Pauwels Type III Femoral Neck Fractures in Young and Middle-Aged Adults: Clinical Follow-Up and Biomechanical Studies","volume":"15","author":"Wen","year":"2023","journal-title":"Orthop. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cha, Y., Chung, J.Y., Jung, C.H., Kim, J.W., Lee, J., Yoo, J.I., Kim, J.T., and Jeon, Y. (2023). Pre-sliding of femoral neck system improves fixation stability in Pauwels type III femoral neck fracture: A finite element analysis. BMC Musculoskelet. Disord., 24.","DOI":"10.1186\/s12891-023-06631-3"},{"key":"ref_18","first-page":"792","article-title":"Comparison of Cannulated Screw Combined with Medial Femoral Plate and Simple Cannulated Screw in the Treatment of Pauwels Type III Femoral Neck Fracture: A Meta-analysis with Trial Sequential Analysis","volume":"33","author":"Li","year":"2023","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zhong, Z., Lan, X., Xiang, Z., and Duan, X. (2023). Femoral neck system and cannulated compression screws in the treatment of non-anatomical reduction Pauwels type-III femoral neck fractures: A finite element analysis. Clin. Biomech., 108.","DOI":"10.1016\/j.clinbiomech.2023.106060"},{"key":"ref_20","first-page":"27","article-title":"Clinical outcomes of fractures affecting both the femoral neck and femoral trochanter","volume":"87","author":"Kijima","year":"2021","journal-title":"Acta Orthop. Belg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"359689","DOI":"10.1155\/2014\/359689","article-title":"The reliability of classifications of proximal femoral fractures with 3-dimensional computed tomography: The new concept of comprehensive classification","volume":"2014","author":"Kijima","year":"2014","journal-title":"Adv. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102015","DOI":"10.1016\/j.jcot.2022.102015","article-title":"eCollection 2022 nov. What is the most fixable intramedullary implant for basicervical fracture and transcervical shear fracture?\u2014A finite element study","volume":"34","author":"Komatsu","year":"2022","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/00005131-200711101-00001","article-title":"Fracture and dislocation classification compendium\u20142007: Orthopaedic Trauma Association classification, database and outcomes committee","volume":"21","author":"Marsh","year":"2007","journal-title":"J. Orthop. Trauma"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00068-022-02079-7","article-title":"Coronal shear fractures of the femoral neck: A comparison with basicervical fractures","volume":"49","author":"Yamakawa","year":"2023","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s007760300026","article-title":"Femoral neck fractures in older patients: Indication for osteosynthesis","volume":"8","author":"Itadera","year":"2003","journal-title":"J. Orthop. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/00003086-200206000-00012","article-title":"Avascular necrosis of the femoral head after femoral neck fracture","volume":"399","author":"Bachiller","year":"2002","journal-title":"Clin. Orthop. Relat. Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/22\/7024\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:20:55Z","timestamp":1760131255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/22\/7024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,10]]},"references-count":26,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["jcm12227024"],"URL":"https:\/\/doi.org\/10.3390\/jcm12227024","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,10]]}}}