Medial Locking Plate Can Increase the Fixation Stability of Vertical Femoral Neck Fracture in Young Adults?

Abstract

Vertical femoral neck fractures in young adults are usually caused by a high-energy trauma. These injuries are difficult to stabilize due to significant shear forces acting on the fracture site. Their treatment is challenging and has a high risk of complications, such as fixation failure, malunion, nonunion and avascular necrosis of the femoral head. In recent years, several studies have focused on the use of direct reduction of vertical femoral neck fractures in young adult patients. This technique allows for anatomical reduction as well as the placement of an intra-articular implant to avoid shear forces at the fracture site. The aim of this study was to evaluate, based on in vitro experimental tests, the biomechanical stability provided by three different fixation methods: (i) dynamic hip screw with derotation screw, (ii) cannulated screws with a conventional medial bone plate and (iii) cannulated screws with a locked medial bone plate. For the biomechanical tests, these techniques were applied to reduce the vertical osteotomy performed on synthetic bones for later verification of the mechanical behavior under axial cyclic loading and destructive axial loading. There were no statistical differences in stiffness, micromovement displacement and mechanical strength during the biomechanical comparison of the fixation methods. Therefore, we conclude that the use of a conventional medial bone plate associated with cannulated screws, with a transverse trochanteric screw, supports the mechanical demand while the fracture is healing and this option can be used to stabilize vertical femoral neck fractures in young patients.