Two-Screw Femoral Neck Fracture Fixation: A Biomechanical Analysis of 2 Different Configurations

In the study reported here, we evaluated 2-screw femoral neck fixation. Femoral necks from 5 paired fresh-frozen cadavers were fractured and then fixed with two 7.3-mm cannulated cancellous screws. Vertical (parallel screws in sagittal plane of femoral neck) and horizontal (parallel screws in superior aspect of femoral neck) configurations were used for each matched pair. Mechanical testing was performed. Load, displacement, and stiffness at the yield point were significantly higher in the horizontal group, which also had a higher mean maximal failure load (P = .019). Preliminary data suggest that 2 horizontal screws in the superior aspect of the femoral neck provide more secure fixation than 2 vertical screws.