• Vincenzo Giordano, Danilo Diniz Alves, Roger Pletsch Paes, Arthur Bonfim Amaral, Marcos Giordano, William Belangero, Anderson Freitas, Hilton A Koch, and do Amaral Ney Pecegueiro NP Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mário Ribeiro 117, Leblon, Rio de Janeiro, RJ, .
• Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mário Ribeiro 117, Leblon, Rio de Janeiro, RJ, 22430-160, Brazil. v_giordano@me.com.
• J Exp Orthop. 2019 May 2; 6 (1): 18.

BackgroundThe biomechanical behavior of Pauwels type III fractures should be taken into consideration when performing internal fixation, since this repair should resist the shear force inherent in the vertical fracture line to the greatest extent possible. Recently, the use of a small fragment plate on the medial face of the femoral neck has been proposed by some authors, with satisfactory initial results. In the current study we analyze the mechanical role a medial plate used as a buttress plate for Pauwels type III femoral neck fractures, comparing the resistance of two fixation configurations using three cannulated screws.MethodsPauwels type III fractures were simulated in synthetic bones models and two groups were created, one of those using two parallel screws at the bottom of the femoral neck and the third screw crossing the fracture horizontally (G1), and the other fixed in the same arrangement as G1, but with the addition of a medial side plate at the apex of the fracture (G2). The constructs were subjected to axial loading until catastrophic failure.ResultsThe addition of a medial plate buttressing the femoral neck increased significantly the resistance to maximum loading (p = 0.003).ConclusionUse of a medial buttress plate results in a mechanically superior construction for Pauwels type III fractures fixed with multiple cannulated screws.Lebel Of EvidenceLevel IV. Biomechanical comparative study.

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