Artificial Intelligence–Augmented Optimization of Cannulated Screw Configurations for Pauwels Type III Femoral Neck Fractures: A Critical Review of Biomechanical and Computational Approaches

Abstract

Around 50% of the world's hip fractures are femoral neck fractures, which are projected to increase by 30% by 2025.Among these fractures, the Pauwels type III fractures are most unstable due to their steep fracture angles, resulting in high shear and rotational stresses.Despite the fact that cannulated screw fixation remains the most costeffective and least invasive method of treatment, high rates of fixation failure in vertically oriented fractures are cause for concern.This review synthesized 2017-2025 experimental, finite element (FE), and computational studies on cannulated screw configurations and their biomechanical performance, and the preliminary orthopaedic utilization of Artificial Intelligence (AI) and Machine Learning (ML).Among the evidence supporting advanced configurations, the oblique triangular configuration arguably provides the best resistance to shear and most favorable stress convergence over the others.TiRobot and TianJi, as well as screw design and spacing, are not fully optimized to enhance the fixation relative to patient anatomy.Combination of the AI and ML will be the future where replace the slow and the computationally expensive FE analysis solvers, thereby enabling near-instantaneous parameteric optimixation.It will improvise the orthopaedic surgery away from empirical methods and clinically adopt biomechanical fixation methods, resulting in smart fixation and advanced orthopedic surgery.

Access to Document

Other files and links

• Link to publication in Scopus
• Open Access Version Available

Fingerprint