{
  "abstract": "Introduction: There is currently a lack of biomechanical evidence regarding whether the central position recommended by guidelines outperforms eccentric positions when using the Femoral Neck System (FNS) for Pauwels type III femoral neck fractures with superior neck defects. This study evaluated the biomechanical stability of FNS placement at different positions (anterior, posterior, central, and inferior) to guide clinical practice.\n\nMethods: A multimodal study combining finite element analysis (FEA) and cadaveric biomechanical testing was conducted on Pauwels III fracture models with 30° wedge-shaped defects in the superior neck. Furthermore, a retrospective analysis was performed on 27 patients who underwent robot-assisted precise central FNS fixation between 2021 and 2025, evaluating postoperative Garden alignment index and the 12-month Harris Hip Score (HHS).\n\nResults: FEA and mechanical testing revealed that eccentric FNS placements caused pronounced stress concentration and structural instability. Conversely, central FNS placement provided maximum structural stiffness and ideal stress distribution. Clinical application of this defect-oriented central strategy yielded excellent Garden alignment, 100% fracture union at the 12-month follow-up, and a mean HHS of 88.41.\n\nDiscussion: In conclusion, for Pauwels type III fractures with superior femoral neck bone defects, precisely placing the bolt in the center of the femoral neck using an orthopedic surgical robot optimizes biomechanical properties and significantly improves fixation stability.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedics, The Second Affiliated Hospital of XuZhou Medical University, Xuzhou, China",
    "Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China",
    "Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing, China",
    "Department of Anatomy, School of Basic Medical Sciences, Xuzhou Medical University, Xuzhou, Jiangsu, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Qing Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xu Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jiawen Wang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Liudong Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiangyu Qi"
    },
    {
      "affs": [
        0
      ],
      "name": "Yongxiang Lv"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenbo Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Yazhong Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Junqiang Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Zhian Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Ziqiang Zhu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2yqxw4s2mv2kn.bib",
  "cited_by": 0,
  "doi": "10.3389/fsurg.2026.1914575",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731223/",
  "id": "2yqxw4s2mv2kn",
  "issns": [
    "2296-875X"
  ],
  "landing_url": "https://doi.org/10.3389/fsurg.2026.1914575",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2746|Hip and Femur Fractures"
    ]
  ],
  "openalex": "W7223126529",
  "pdf_url": "https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1914575/pdf",
  "pmcid": "PMC13731223",
  "pmid": "42984753",
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/2yqxw4s2mv2kn.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:27Z",
      "native_id": "PMC13731223",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fsurg.2026.1914575"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Hip and Femur Fractures",
      "subfield": "surgery"
    }
  ],
  "title": "Effects of variable bolt position of femoral neck system on Pauwels III fractures with superior femoral neck bone defect: multimodal biomechanical and clinical study",
  "title_text": "Effects of variable bolt position of femoral neck system on Pauwels III fractures with superior femoral neck bone defect: multimodal biomechanical and clinical study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:27Z",
  "url": "https://research.draconitic.com/paper/2yqxw4s2mv2kn",
  "venue": "Frontiers in Surgery",
  "versions": []
}