In this study, the biomechanical differences among three internal fixation configurations for treatment of Pauwels type II and III femoral neck fractures were analyzed. Using finite element analysis, the femur displacement and stress distributions of the internal fixation device and fracture section were obtained for different patients and movement conditions. The results show that patients with osteoporosis are more prone to femoral varus and femoral neck shortening, and the fracture probability of the device for these patients is higher than that for patients with normal bone. The treatment effect of the inverted-triangle screw (ITS) fixation and proximal femoral nail anti-rotation (PFNA) fixation is better than that of dynamic hip screw (DHS) fixation. The ITS fixation is more suitable for the treatment of the normal bone patients with Pauwels II femur neck fracture. However, the PFNA fixation has better biomechanical advantages and better capability for anti-femoral neck shortening. Therefore, it is suitable for the treatment of femoral neck fracture patients with osteoporosis.
Keywords: Femoral neck fracture; finite element analysis; fixation configuration; osteoporosis.