Cannulated Compression Screw Placement for Swine Femoral Neck Fracture to Protect the Main Intraosseous Arteries

Femoral head necrosis is a common and serious complication of femoral neck fractures, primarily attributed to disrupted blood supply. This study introduces a novel method of placing cannulated compression screws in swine femoral neck fractures, designed to protect the blood supply to the femoral head while ensuring mechanical stability. Using microscopic perfusion techniques and 3D technology (via Materialise 3-Matic11.0 and Materialise Magics 21.0 software), we created perfusion and corrosion casting specimens of the intraosseous arteries from 21 fresh swine proximal femurs. The spatial distribution of the arteries was analyzed, and screw placement simulations were conducted on 3D scans to avoid damaging the main intraosseous arteries. Two screws were then placed on real casting specimens, resulting in minimal arterial damage. Biomechanical tests on 16 femoral neck fracture models showed no significant differences between the new method and the traditional two-screw method in terms of compression strength and maximal vertical loading. This study demonstrates an innovative screw placement technique that effectively protects the blood supply to the femoral head while maintaining mechanical stability comparable to traditional methods. The clinical implications are significant—this approach could reduce the incidence of femoral head necrosis, improve patient outcomes and decrease related complications. By balancing blood supply preservation with mechanical stability, this method offers a promising strategy for the management of femoral neck fractures.