Novel internal fixation technique for Pauwels type III neck of femur fractures using the femoral neck system in conjunction with a medial buttress plate: a case report

Background: Femoral neck fractures in patients under 50 years of age are rare and primarily associated with high energy trauma. We documented the use of a novel internal fixation technique to manage a Pauwels type III fracture, which presents significant biomechanical challenges in treatment. Materials and Methods: A 37-year-old man sustained a Pauwels type III fracture after a sports injury. The combination of the Femoral Neck System in conjunction with a medial buttress plate was used to enhance fixation stability. Postoperative X-rays and outcomes are presented. This technique was replicated in a second patient with a similar fracture and outcomes monitored during routine follow-up. Results: Both procedures were performed without complication. Successful fracture union was achieved, with no evidence of osteonecrosis or hardware failure on follow-up over the course of 1 year. Conclusion: The combined approach of the Femoral Neck System with a medial buttress plate provides a promising solution to the biomechanical challenges associated with high-angle femoral neck fractures. This approach may offer enhanced fixation stability in young patients with high-energy trauma.